Journal Mobile Options
Table of Contents
Vol. 29, No. 6, 2010
Issue release date: July 2010
Dement Geriatr Cogn Disord 2010;29:510–515
(DOI:10.1159/000305100)

Rivastigmine in the Treatment of Dementia Associated with Parkinson’s Disease: Effects on Activities of Daily Living

Olin J.T. · Aarsland D. · Meng X.
aNovartis Pharmaceuticals Corporation, East Hanover, N.J., USA; bStavanger University Hospital, Stavanger, Norway

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Aims: To investigate the effects of rivastigmine capsule 3–12 mg/day over 24 weeks on activities of daily living (ADLs) in patients with dementia associated with Parkinson’s disease (PDD). Methods: Post hocanalysis of a prospective, multicenter, randomized, double-blind, placebo-controlled trial in patients with PDD (≧50 years) randomized to rivastigmine 3–12 mg/day (capsules bid) or placebo over 24 weeks. This analysis was carried out with three subscales derived from a factor analysis of the 23 items in the Alzheimer’s Disease Cooperative Study – Activities of Daily Living (ADCS-ADL) scale. These subscales were basic ADLs (10 items), high-level function ADLs (eight items) and autonomy ADLs (five items). Results: 541 patients were randomized (362 to rivastigmine, 179 to placebo) and 410 (75.8%) completed the study. Rivastigmine was associated with significantly better outcomes in basic ADLs (–0.5 ± 6.19 vs. –1.7 ± 5.46; p = 0.025; effect size 22.1%) and high-level function ADLs (0.1 ± 4.95 vs. –1.0 ± 4.49; p = 0.017; effect size 22.9%) compared with placebo, at week 24. Conclusion: In patients with PDD, treatment with rivastigmine may show beneficial effects on overall ADLs, as well as modest, statistically significant improvements in basic ADLs and high-level function ADLs.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Aarsland D, Andersen K, Larsen JP, Lolk A, Nielsen H, Kragh-Sorensen P: Risk of dementia in Parkinson’s disease: a community-based, prospective study. Neurology 2001;56:730–736.
  2. Hobson P, Meara J: Risk and incidence of dementia in a cohort of older subjects with Parkinson’s disease in the United Kingdom. Mov Disord 2004;19:1043–1049.
  3. Buter TC, van den Hout A, Matthews FE, Larsen JP, Brayne C, Aarsland D: Dementia and survival in Parkinson disease: a 12-year population study. Neurology 2008;70:1017–1022.
  4. Aarsland D, Andersen K, Larsen JP, Lolk A, Kragh-Sorensen P: Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. Arch Neurol 2003;60:387–392.
  5. Hely MA, Reid WG, Adena MA, Halliday GM, Morris JG: The Sydney multicenter study of Parkinson’s disease: the inevitability of dementia at 20 years. Mov Disord 2008;23:837–844.
  6. Huber SJ, Paulson GW, Shuttleworth EC: Relationship of motor symptoms, intellectual impairment, and depression in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1988;51:855–858.
  7. Bronnick K, Ehrt U, Emre M, De Deyn PP, Wesnes K, Tekin S, Aarsland D: Attentional deficits affect activities of daily living in dementia-associated with Parkinson’s disease. J Neurol Neurosurg Psychiatry 2006;77:1136–1142.
  8. Allan L, McKeith I, Ballard C, Kenny RA: The prevalence of autonomic symptoms in dementia and their association with physical activity, activities of daily living and quality of life. Dement Geriatr Cogn Disord 2006;22:230–237.
  9. Schrag A, Jahanshahi M, Quinn N: What contributes to quality of life in patients with Parkinson’s disease? J Neurol Neurosurg Psychiatry 2000;69:308–312.
  10. McKinlay A, Grace RC, Dalrymple-Alford JC, Anderson T, Fink J, Roger D: A profile of neuropsychiatric problems and their relationship to quality of life for Parkinson’s disease patients without dementia. Parkinsonism Relat Disord 2008;14:37–42.
  11. Aarsland D, Bronnick K, Ehrt U, De Deyn PP, Tekin S, Emre M, Cummings JL: Neuropsychiatric symptoms in patients with Parkinson’s disease and dementia: frequency, profile and associated care giver stress. J Neurol Neurosurg Psychiatry 2007;78:36–42.
  12. Aarsland D, Larsen JP, Karlsen K, Lim NG, Tandberg E: Mental symptoms in Parkinson’s disease are important contributors to caregiver distress. Int J Geriatr Psychiatry 1999;14:866–874.
  13. Stella F, Banzato CE, Quagliato EM, Viana MA, Christofoletti G: Psychopathological features in patients with Parkinson’s disease and related caregivers’ burden. Int J Geriatr Psychiatry 2009.
  14. Andersen CK, Wittrup-Jensen KU, Lolk A, Andersen K, Kragh-Sorensen P: Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health Qual Life Outcomes 2004;2:52.
  15. Marras C, Lang A: Invited article: Changing concepts in Parkinson disease: Moving beyond the decade of the brain. Neurology 2008;70:1996–2003.
  16. Braak H, Ghebremedhin E, Rub U, Bratzke H, Del Tredici K: Stages in the development of Parkinson’s disease-related pathology. Cell Tissue Res 2004;318:121–134.
  17. Farlow MR, Miller ML, Pejovic V: Treatment options in Alzheimer’s disease: maximizing benefit, managing expectations. Dement Geriatr Cogn Disord 2008;25:408–422.
  18. Emre M: Treatment of dementia associated with Parkinson’s disease. Parkinsonism Relat Disord 2007;13(suppl 3):S457–S461.
  19. Bohnen NI, Kaufer DI, Ivanco LS, Lopresti B, Koeppe RA, Davis JG, Mathis CA, Moore RY, DeKosky ST: Cortical cholinergic function is more severely affected in parkinsonian dementia than in Alzheimer disease: an in vivo positron emission tomographic study. Arch Neurol 2003;60:1745–1748.
  20. Bohnen NI, Kaufer DI, Hendrickson R, Ivanco LS, Lopresti BJ, Constantine GM, Mathis Ch A, Davis JG, Moore RY, Dekosky ST: Cognitive correlates of cortical cholinergic denervation in Parkinson’s disease and parkinsonian dementia. J Neurol 2006;253:242–247.
  21. Perry EK, Curtis M, Dick DJ, Candy JM, Atack JR, Bloxham CA, Blessed G, Fairbairn A, Tomlinson BE, Perry RH: Cholinergic correlates of cognitive impairment in Parkinson’s disease: comparisons with Alzheimer’s disease. J Neurol Neurosurg Psychiatry 1985;48:413–421.
  22. Hilker R, Thomas AV, Klein JC, Weisenbach S, Kalbe E, Burghaus L, Jacobs AH, Herholz K, Heiss WD: Dementia in Parkinson disease: functional imaging of cholinergic and dopaminergic pathways. Neurology 2005;65:1716–1722.
  23. Novartis Pharmaceuticals Corporation. Exelon Capsule: Prescribing information.
  24. Novartis Pharmaceuticals Corporation. Exelon Transdermal Patch: Prescribing information.
  25. Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, De Deyn PP, Durif F, Kulisevsky J, van Laar T, Lees A, Poewe W, Robillard A, Rosa MM, Wolters E, Quarg P, Tekin S, Lane R: Rivastigmine for dementia associated with Parkinson’s disease. N Engl J Med 2004;351:2509–2518.
  26. Gibb WR, Lees AJ: The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 1988;51:745–752.
  27. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4, text revision (DSM-IV-TR®). Arlington, American Psychiatric Press, 1994.
  28. Galasko D, Bennett D, Sano M, Ernesto C, Thomas R, Grundman M, Ferris S: An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997;11(suppl 2):S33–S39.
  29. Feldman HH, Schmitt FA, Olin JT; Group MM-M-S: Activities of daily living in moderate-to-severe Alzheimer disease: an analysis of the treatment effects of memantine in patients receiving stable donepezil treatment. Alzheimer Dis Assoc Disord 2006;20:263–268.
  30. Wesnes KA, McKeith I, Edgar C, Emre M, Lane R: Benefits of rivastigmine on attention in dementia associated with Parkinson disease. Neurology 2005;65:1654–1656.
  31. Wesnes K, Edgar C, O’Brien JT: Rivastigmine reduces the attentional deficit in dementia associated with Parkinson’s disease and treatment response is dependent on the initial severity of the deficits. Int Psychogeriatr 2005;17:263–264.

    External Resources

  32. Cifu DX, Carne W, Brown R, Pegg P, Ong J, Qutubuddin A, Baron MS: Caregiver distress in parkinsonism. J Rehabil Res Dev 2006;43:499–508.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50