Treatment Effect of Donepezil is Greater in Moderate Stage Than in Mild Stage of Alzheimer's Disease

Abstract

Background: Alzheimer’s disease (AD) is a progressive disease with an insidious onset and a downhill course. Treatment response of cholinesterase inhibitors for AD seems to depend on severity degree but it is not clear which stage is more responsive. Methods: This was a 1 year, retrospective cohort study. AD patients (very mild, 188; mild, 153; moderate, 31) were recruited from the memory impairment clinic at Pusan National University Hospital of South Korea. Mean differences (score at the end of one-year follow up - score at baseline) in the Clinical Dementia Rating Sum of Boxes (CDRSOB) were used as the primary efficacy measures. Patients initially received 5 mg/day donepezil for first 1 month, then 10 mg/day for the remainder of the study. Results: Declining rates of the CDR 0.5 and the CDR 1 have higher declining rate in CDRSOB than the CDR 2 group. Conclusion: This study shows that the rate of cognitive decline is less in moderate AD than other stage of AD. This suggests that treatment effect of donepezil may be greater in moderate stage than in mild stage of AD. doi: http://dx.doi.org/10.4021/jnr178w