Specific symptomatic changes following donepezil treatment of Alzheimer's disease: a multi-centre, primary care, open-label study
Article first published online: 27 SEP 2006
Copyright © 2006 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 22, Issue 4, pages 312–319, April 2007
How to Cite
Rockwood, K., Black, S., Bedard, M.-A., Tran, T. and Lussier, I. (2007), Specific symptomatic changes following donepezil treatment of Alzheimer's disease: a multi-centre, primary care, open-label study. Int. J. Geriat. Psychiatry, 22: 312–319. doi: 10.1002/gps.1675
- Issue published online: 21 MAR 2007
- Article first published online: 27 SEP 2006
- Manuscript Accepted: 7 AUG 2006
- Manuscript Received: 3 AUG 2006
- Pfizer Canada
- Alzheimer's disease;
- clinical meaningfulness;
- clinical scales;
Standard measurement scales used in anti-dementia trials may not capture symptomatic changes recognized by clinicians and caregivers. We studied a symptom checklist, completed separately by caregivers and by clinicians, to identify patterns of change associated with donepezil treatment.
In a multi-centre, 6-month, open-label study of 101 primary care patients, changes in a 19-symptom checklist were assessed in relation to changes in standardized scales of cognition, activities of daily living, behavior, and caregiver burden.
Three symptoms were reported in more than 80% of patients by both clinicians and caregivers: problems in remembering, (97%), temporal orientation (89%), and repetitiveness (85%). Five others overlapped on each of the clinician and caregiver ‘top ten’, including cognitive activation, spatial orientation, leisure, attention, and apathy. Clinicians reported that symptoms did not improve in 38 patients, whereas there was some improvement in 43, and improvement in most symptoms in 20. Caregivers reported that symptoms did not improve in 55 patients, whereas 27 and 19 patients showed some and most symptoms improving respectively. Patients with the greatest symptomatic improvement also improved most on the ADAS-Cog and the other standardized measures, whereas no improvement (or decline) in each standardized measure was observed in people whose symptoms worsened or did not improve.
A symptom checklist allowed clinically meaningful profiles to be identified, but revealed different estimates of response between clinicians and caregivers. Both agreed that improved executive function was the most common response. A symptom checklist can help translate between standard measures and everyday practice. Copyright © 2006 John Wiley & Sons, Ltd.