Long-term outcome and prediction models of activities of daily living in Alzheimer disease with cholinesterase inhibitor treatment
Abstract
In untreated patients with Alzheimer disease (AD) the functional ability is gradually lost. What happens to the patients after continuous long-term cholinesterase inhibitor (ChEI) treatment is less investigated. The objective of this study was to describe the longitudinal functional outcome and analyze factors affecting the outcome in ChEI-treated patients. In an open, 3-year, nonrandomized, prospective, multicenter study in a routine clinical setting, 790 patients were treated with either donepezil, rivastigmine, or galantamine. At baseline and every 6 months, they were assessed with several rating scales including Instrumental Activities of Daily Living (IADL), Physical Self-Maintenance Scale (PSMS), and Mini-Mental State Examination (MMSE). A faster functional decline was associated with lower cognitive ability at baseline, older age, and the interaction of higher education and longer time in the study. The patients residing with a spouse or relative showed slower deterioration in IADL score. A higher mean dose of ChEI, regardless of drug agent, was also related to slower instrumental ADL decline. Prediction models for longitudinal functional outcome were provided. AD severity at baseline is a key factor in obtaining reliable clinical prognoses of the long-term ADL ability. The dosage of ChEI treatment could possibly lead to a different functional outcome.
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Longer term benefits of cholinesterase inhibitors, from 2 to 4 or more years, have been demonstrated in open-label extension and long-term prospective observational clinical cohort studies.
“Longer term benefits, from 2 to 4 or more years have been demonstrated in open-label extension 69,[88][89][90] and long-term prospective observational clinical cohort studies.[91][92][93][94][95]”
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- Authors
- Wattmo, C., Wallin, Å. K., Londos, E., & Minthon, L.
- Affiliations
- Lund University (SE)
- Venue
- Alzheimer Disease & Associated Disorders
- Published
- 2011-01
- Volume
- 25
- Issue
- 1
- Pages
- 63-72
- ISSN
- 0893-0341 (ISSN-L)
- OpenAlex
- W2008759843
- Cited by
- 52
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2022: 4 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 7 · 2014: 8 · 2013: 10 · 2012: 4
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alzheimer Disease & Associated Disorders (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Lunds Universitet
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- Alzheimer's disease, cholinesterase inhibitors, activities of daily living, instrumental activities of daily living, functional decline, donepezil, rivastigmine, galantamine, prediction model, long-term outcomes, cognitive impairment, dose-response relationship, living arrangements
- MeSH terms
- Rivastigmine, Donepezil, Activities of Daily Living, Aged, Alzheimer Disease, Cholinesterase Inhibitors, Dose-Response Relationship, Drug, Female, Galantamine, Humans, Indans, Longitudinal Studies, Male, Neuropsychological Tests, Piperidines, Treatment Outcome, Disease Progression, Phenylcarbamates
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