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Donepezil Effective in Patients with Vascular Dementia: Presented at AAGP

By Bonnie Darves

HONOLULU, HA -- March 7, 2003 -- Patients who have vascular dementia but who have not had a stroke or been diagnosed with cerebrovascular disease may see benefits in cognitive and global function after treatment with donepezil (Aricept).

An estimated 20% of patients with dementia have vascular dementia, and that number is expected to grow as the population ages.

Researchers led by Stephen P. Salloway, from Brown Medical School in Providence, Rhode Island, United States, presented findings of their study here March 4^th at the Annual Meeting of the American Association for Geriatric Psychiatry.

The study, an analysis of two randomised, 24-week, double-blind trials, included 1,219 patients -- mean age 74.5 years, 73% diagnosed with probable vascular dementia, based on criteria from NINDS-AIREN (National Institute of Neurological Disorders and Stroke–Association Internationale pour la Recherche et l'Enseignement en Neurosciences).

Patients received 5 mg (n=406) to 10 mg (n=421) daily doses of donepezil or placebo (n=392) and were assessed at baseline and weeks 6, 12, 18 and 24.

Baseline function and drug efficacy were measured based on Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-Cog), and Clinical Dementia Rating - Sum of the Boxes scores. Mean ADAS-Cog and MMSE scores were 22.9 and 21.5, respectively, at baseline.

All patients treated with donepezil showed less cognitive decline than those on placebo over the course of the study. Patients on the 5 mg dose had an ADAS-Cog mean change of –1.89 from baseline to week 24; for the 10 mg group, the change was –2.38. Global function also improved, with 41% of the 5 mg group and 33% in the 10 mg group exhibiting improved function.

Improvements were also seen in activities of daily living scores between baseline and Week 18, but those improvements began to diminish between weeks 18 and 24. Approximately 30% of patients in the treatment groups discontinued treatment because of adverse events.

Despite only modest improvements in some patients, the researchers said donepezil may play an important role in management of patients with vascular dementia.


[Study title: Donepezil Provides Significant Benefits in Patients with Vascular Dementia. Abstract PO-77]

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