Donepezil in Alzheimer’s Disease: What to Expect after 3 Years of Treatment in a Routine Clinical SettingWallin Å.K. · Andreasen N. · Eriksson S. · Båtsman S. · Näsman B. · Ekdahl A. · Kilander L. · Grut M. · Rydén M. · Wallin A. · Jonsson M. · Olofsson H. · Londos E. · Wattmo C. · Eriksdotter Jönhagen M. · Minthon L.
aClinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Malmö, bKarolinska Institutet, Alzheimer’s Disease Research Center, Department of Neurotec, Division of Geriatric Medicine, Karolinska University Hospital, Huddinge, Stockholm, cSection of Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, dDepartment of Primary Care, Kalix Vårdcentral, Kalix, eDepartment of Geriatric Medicine University Hospital Linköping, Linköping, fDepartment of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, gDepartment of Geriatric Medicine, Cognitive Section Danderyd Hospital, Danderyd, hInstitute of Neuroscience, Section of Psychiatry, Göteborg/Sahlgrenska University Hospital, Mölndal, and iMemory Clinic, Uddevalla Hospital, Uddevalla, Sweden
Background/Aims: Clinical short-term trails have shown positive effects of donepezil treatment in patients with Alzheimer’s disease. The outcome of continuous long-term treatment in the routine clinical settings remains to be investigated. Methods: The Swedish Alzheimer Treatment Study (SATS) is a descriptive, prospective, longitudinal, multicentre study. Four hundred and thirty-five outpatients with the clinical diagnosis of Alzheimer’s disease, received treatment with donepezil. Patients were assessed with Mini-Mental State Examination (MMSE), Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog), global rating (CIBIC) and Instrumental Activities of Daily Living (IADL) at baseline and every 6 months for a total period of 3 years. Results: The mean MMSE change from baseline was positive for more than 6 months and in subgroups of patients for 12 months. After 3 years of treatment the mean change from baseline in MMSE-score was 3.8 points (95% CI, 3.0–4.7) and the ADAS-cog rise was 8.2 points (95% CI, 6.4–10.1). This is better than expected in untreated historical cohorts, and better than the ADAS-cog rise calculated by the Stern equation (15.6 points; 95% CI, 14.5–16.6). After 3 years with 38% of the patients remaining, 30% of the them were unchanged or improved in the global assessment. Conclusion: Three-year donepezil treatment showed a positive global and cognitive outcome in the routine clinical setting.