Cholinesterase inhibitor at different doses in treating patients with Alzheimer's disease and their correlative research

Abstract

Objective To compare the effects of different doses ofdonepezil,the cholinesterase inhibitor,on patients with mild to moderate Alzheimer's disease (AD) and analyze the correlations of different rating scales of AD so as to choose a better evaluation tool for AD treatment efficacy.Methods Sixty-nine AD patients,admitted to our hospital from January 2010 to November 2010,were randomly divided into 5 mg donepezil treatment group (n=33) and 10 mg donepezil treatment group (n=36); the treatments were given daily for a consecutive 12 months.They were performed Mini Mental State Examination (MMSE),Alzheimer's Disease Assessment Scale-cognitive sub scale (ADAS-cog),activities of daily living (ADL) and instrumental activities of daily living (LADL) every 3 months (3,6,9 and 12 months after the first evaluation time). Results Improvements were noted in both groups on MMSE scores,ADAS-cog scores,ADL scores,IADL scores,and latency of P300 and N200:the MMSE scores,ADAS-cog scores and latency of P300 in the 10 mg treatment group were obviously higher/longer than those in the 5 mg treatment group.Relation between MMSE scores and ADAS-cog scores was noted (r=-0.378,P=0.001).No relation was noted on neuro-psychology and electrophysiology of these patients (P＞0.05). Conclusion Donepezil is safe and effective in improving cognition of patients with mild to moderate AD,and has obvious dose-effect:the efficacy of 10 mg donepezil is superior to that of 5 mg donepezil; the parameters of cognitive assessment in neuro-psychology were found having relation with each other,which can be used with combination to improve the evaluation efficacy. Key words: Alzheimer's disease; Cholinesterase inhibitor; Neuropsychological test; Event-related potential