The cognitive effects of cholinesterase inhibitor treatment in every-day practice

ABSTRACT

Objective: Cholinesterase inhibitors (ChEIs) are the treatment of choice in Alzheimer's disease (AD). Their efficacy has been proven in many clinical trials. The aim of the present study was to confirm their cognitive benefit in every day practice as to whether it is similar to that expected from clinical trials.

Patients and methods: We reviewed the files of 41 patients suffering from AD or mixed dementia and treated by ChEIs in terms of every day practice.

Results: During the first year MMSE scores remained better than or at baseline levels. Following that a gradual decline was noted. However, at any time point, the observed scores were significantly better than the expected ones calculated according to the pre-treatment rate of decline. The post-treatment rate of decline was significantly better than the pre-treatment one, while progression to the next stage of dementia was delayed by 8 months.

Conclusion: The present observations from every-day practice indicate that there is a small but significant effect of ChEIs in cognition, similar to that observed in clinical trials. Furthermore, a small but significant delay in dementia progression may occur after treatment with ChEIs.

Key words: :

• Alzheimer's disease
• Cholinesterase inhibitors
• Donepezil
• Galantamine
• Mixed dementia
• Rivastigmine