Donepezil for dementia with Lewy bodies: A randomized, placebo-controlled trial
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TLDR
Because cholinergic deficits are prominent in dementia with Lewy bodies, the effects of a cholinesterase inhibitor, donepezil, in such patients in a randomized, double‐blind, placebo‐controlled exploratory phase 2 trial are investigated.Abstract:
Objective Because cholinergic deficits are prominent in dementia with Lewy bodies (DLB), we investigated the effects of a cholinesterase inhibitor, donepezil, in such patients in a randomized, double-blind, placebo-controlled exploratory phase 2 trial. Methods One-hundred forty patients with DLB, recruited from 48 specialty centers in Japan, were randomly assigned to receive placebo or 3, 5, or 10 mg of donepezil hydrochloride daily for 12 weeks (n = 35, 35, 33, and 37, respectively). Effects on cognitive function were assessed using the Mini-Mental State Examination (MMSE) and several domain-specific neuropsychological tests. Changes in behavior were evaluated using the Neuropsychiatric Inventory, caregiver burden using the Zarit Caregiver Burden Interview, and global function using the Clinician's Interview-Based Impression of Change-plus Caregiver Input (CIBIC-plus). Safety measures included the Unified Parkinson's Disease Rating Scale part III. Results Donepezil at 5 and 10 mg/day was significantly superior to placebo on both the MMSE (5 mg: mean difference, 3.8; 95% confidence interval [CI], 2.3-5.3; p Interpretation Donepezil at 5 and 10mg/day produces significant cognitive, behavioral, and global improvements that last at least 12 weeks in DLB patients, reducing caregiver burden at the highest dose. Donepezil is safe and well tolerated.read more
Citations
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Dementia prevention, intervention, and care
Gill Livingston,Gill Livingston,Andrew Sommerlad,Vasiliki Orgeta,Sergi G. Costafreda,Sergi G. Costafreda,Jonathan Huntley,Jonathan Huntley,David Ames,Clive Ballard,Sube Banerjee,Alistair Burns,Jiska Cohen-Mansfield,Claudia Cooper,Claudia Cooper,Nick C. Fox,Laura N. Gitlin,Robert Howard,Robert Howard,Helen C. Kales,Eric B. Larson,Eric B. Larson,Karen Ritchie,Karen Ritchie,Kenneth Rockwood,Elizabeth L Sampson,Quincy M. Samus,Lon S. Schneider,Geir Selbæk,Geir Selbæk,Linda Teri,Naaheed Mukadam +31 more
TL;DR: The Lancet Commission on Dementia Prevention, Intervention, and Care met to consolidate the huge strides that have been made and the emerging knowledge as to what the authors should do to prevent and manage dementia.
Book
Dementia With Lewy Bodies
TL;DR: The current state of scientific knowledge on DLB is reviewed to show that treatment with cholinesterase inhibitors is well tolerated by most patients and substantially improves cognitive and neuropsychiatric symptoms.
Journal ArticleDOI
Lewy body dementias
Zuzana Walker,Zuzana Walker,Katherine L. Possin,Bradley F Boeve,Dag Aarsland,Dag Aarsland,Dag Aarsland +6 more
TL;DR: The most pertinent progress from the past 10 years is summarized, outlining some of the challenges for the future, which will require refinement of diagnosis and clarification of the pathogenesis, leading to disease-modifying treatments.
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Screening for Cognitive Impairment in Older Adults: A Systematic Review for the U.S. Preventive Services Task Force
TL;DR: Brief instruments to screen for cognitive impairment can adequately detect dementia, but there is no empirical evidence that screening improves decision making.
Journal ArticleDOI
Efficacy and safety of cholinesterase inhibitors and memantine in cognitive impairment in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies: systematic review with meta-analysis and trial sequential analysis
Hui-Fu Wang,Jin-Tai Yu,Shaowen Tang,Teng Jiang,Chen-Chen Tan,Xiangfei Meng,Chong Wang,Meng-Shan Tan,Lan Tan +8 more
TL;DR: Cholinesterase inhibitors and memantine slightly improve global impression; however, only cholines terase inhibitors enhance cognitive function.
References
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Journal ArticleDOI
“Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician
Marshal F. Folstein,Marshal F. Folstein,Susan E B Folstein,Susan E B Folstein,Paul R. McHugh,Paul R. McHugh +5 more
TL;DR: A simplified, scored form of the cognitive mental status examination, the “Mini-Mental State” (MMS) which includes eleven questions, requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
A practical method for grading the cognitive state of patients for the clinician
TL;DR: The Mini-Mental State (MMS) as mentioned in this paper is a simplified version of the standard WAIS with eleven questions and requires only 5-10 min to administer, and is therefore practical to use serially and routinely.
Journal ArticleDOI
Parkinsonism: Onset, progression, and mortality
Margaret M. Hoehn,Melvin D. Yahr +1 more
TL;DR: Controversy over the effectiveness of therapeutic measures for parkinsonism is due partially to this wide variability and to the paucity of clinical information about the natural history of the syndrome.
Journal ArticleDOI
The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia
Jeffrey L. Cummings,Michael S. Mega,Kevin F. Gray,S. Rosenberg-Thompson,Daniela Carusi,Jeffrey Gornbein +5 more
TL;DR: The NPI has the advantages of evaluating a wider range of psychopathology than existing instruments, soliciting information that may distinguish among different etiologies of dementia, differentiating between severity and frequency of behavioral changes, and minimizing administration time.
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