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Donepezil Beneficial For Severe Dementia and Neuropsychiatric Symptoms in Elderly: Presented at CPA
By Donalee Moulton
HALIFAX, CANADA -- November 5, 2003 -- Donepezil appears to be beneficial to nursing-home patients with severe dementia who have clinically significant neuropsychiatric symptoms, according to the results of a recent study presented here November 2nd during the 53rd Annual Meeting of the Canadian Psychiatric Association.
Francois Rousseau, MD, psychiatrist, Robert-Giffard Hospital and Laval University, Quebec City, Canada, presented results of an open-label pilot study with 24 subjects. All participants had clinically significant neuropsychiatric symptoms not currently being controlled by medication.
Over a period of 24 weeks, participants received either 5 mg/day or 10 mg/day of donepezil. They were assessed every 4 weeks for the first 3 months, then every 6 weeks until the end of the study. The primary instrument used to measure changes was the Neuropsychiatric Inventory (Nursing Home version), which contains 12 items designed to assess behavioural disturbances in demented individuals, and includes a caregiver component.
The study results indicate that, at baseline, 75% of participants were classified as either a 6D or 6E on the Functional Assessment of Staging Scale. In spite of the advanced stages of dementia, however, cognition and function were maintained in participants over the course of the study, said Dr. Rousseau.
Statistically significant improvements were noted on the Neuropsychiatric Inventory at each assessment point, beginning in week 8 and moving forward to the final week of the study. Eleven of the 12 subscales for caregivers indicated results favourable to the use of donepezil in this study population. Scores also improved significantly on key measures, including anxiety, elation, irritability and agitation/aggression.
"These results are in line with previous studies conducted among mild-to-moderate and moderate-to-severe subjects," noted Dr. Rousseau. "Maintenance of functioning in this [advanced dementia] group represents a positive treatment outcome," he concluded.
[Study Title: Donepezil Treatment of Clinically Significant Psychiatric Symptoms in Nursing Home Patients Suffering from Dementia. Abstract P1-21]
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