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Reference (APA Format)

Behl P., Lanctot K.L., Streiner D.L. & Black S.E. 2006. Chronic treatment with cholinesterase inhibitors slows decline in overall and selective cognitive domains in Alzheimer’s disease (AD): A 2-year observational study in the Sunnybrook Dementia Cohort. ALZHEIMER’S & DEMENTIA, 2 (3), S362.

Title

Chronic treatment with cholinesterase inhibitors slows decline in overall and selective cognitive domains in Alzheimer’s disease (AD): A 2-year observational study in the Sunnybrook Dementia Cohort

Journal Name

ALZHEIMER’S & DEMENTIA

Abstract

Background: Given that AD usually runs a course of 5 to 10 years from onset of symptoms, it is important to assess the effects of second-generation cholinesterase inhibitors (CHIs) over longer time periods. Despite widespread use of CHIs, surprisingly little is known about possible effects in different cognitive domains over one year. Objective(s): To assess selective and overall cognitive treatment effects of CHIs over two years in a cohort group-matched to untreated controls in the same longitudinal observational study. Methods: Participants (Untreated34, Treated58) meeting NINCDS-ADRDA criteria for mild or moderate probable AD seen at a university memory clinic underwent standardized neuropsychological, functional, and behavioral assessments at baseline, one year F/U (Mean F/U 1 13 months) and two years F/U (Mean F/U 2  30.5 months) (NSD in the F/U between the two groups). Groups received an extensive evaluation on comorbid illnesses, concomitant medications, and vascular risk factors. Results: There were no significant differences between the two groups in the detailed medical evaluations and on baseline demographics including age, education, duration, Mini Mental State Examination (MMSE), Dementia Rating Scale (DRS) total score, and Disability Assessment for Dementia Scale (DAD) total score. Repeated measures MANOVA on the MMSE, DRS total score, and similar analyses with Bonferroni correction on its 5 subscores, standardized tests of memory (CVLT acquisition and delayed free recall scores), language (Boston Naming), visuospatial (Rey Copy) and executive functioning (Phonemic Fluency {FAS}), revealed a significant group by time interaction (p0.027) with post-hoc comparisons showing significantly less decline in treated patients in overall MMSE, total DRS and conceptualization subscore. Less decline was also seen in the CVLT acquisition score (trials 1-5) and Boston Naming with moderate to large effect sizes. Conclusions: Treated patients declined more slowly in overall cognition, abstract concept formation skills, acquisition (encoding and retrieval) and naming. Durable effects were seen over two years in treated vs. untreated mild AD not only in memory and language, but also globally and particularly in some executive (left frontal) functions.

Volume

2 (3)

Year

2006

Pages

S362

Authors

Behl P., Lanctot K.L., Streiner D.L. & Black S.E.

Conference Title

ICAD 2006: 10th International Conference on Alzheimer's Disease and Related Disorders

Conference Host

Alzheimer’s & Dementia

Presentation Type

Abstract

Location

Madrid, Spain (July 15 - 20, 2006)

More Information

The Journal of the Alzheimer's Association, Supplement P2-396