Five-year outcome of cholinergic treatment of Alzheimer's disease: early response predicts prolonged time until nursing home placement, but does not alter life expectancy
Abstract
Fifty consecutive outpatients with Alzheimer's disease (AD) received treatment with the cholinesterase inhibitor tacrine in an open longitudinal study. Assessments using Mini-Mental State Examination, Alzheimer's Disease Assessment Scale - cognitive subscale, and a global rating were made at baseline and at 6, 12, 24, 36, 48 and 60 months. Three outcome groups were characterized: responders, unchanged and deteriorated. Additional outcome measures were time until nursing home placement, and mortality rate. At 6 months -75%, at 12 months -42%, at 24 months -20%, and after that 10% of the patients still on medication had improved or remained stable. The mortality rate did not differ between the outcome groups. Response to tacrine treatment at 6 or 12 months was found to predict a prolonged time until nursing home placement. No predictors for a positive treatment response could be identified at baseline.
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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]”
From The Alzheimer’s Disease Clinical Spectrum (2019) · cites this paper as [94]
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Self-citation
- Authors
- Wallin, Å. K., Gustafson, L., Sjögren, M., Wattmo, C., & Minthon, L.
- Affiliations
- Lund University (SE)
- Skåne University Hospital (SE)
- Venue
- Dementia and Geriatric Cognitive Disorders
- Publisher
- S. Karger AG
- Published
- 2004
- Volume
- 18
- Issue
- 2
- Pages
- 197-206
- ISSN
- 1420-8008 (ISSN-L)
- 1421-9824
- OpenAlex
- W1987985059
- Cited by
- 45
- References
- 40
- Citations by year
- 2026: 1 · 2022: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2015: 4 · 2014: 1 · 2013: 3 · 2012: 1
- FWCI
- 2.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Dementia and Geriatric Cognitive Disorders (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Lunds Universitet
- Alzheimerfonden
- 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, tacrine, cholinesterase inhibitors, treatment response, nursing home admission, mortality, cognitive decline, long-term outcomes, predictors of treatment response
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Cholinesterase Inhibitors, Dose-Response Relationship, Drug, Female, Homes for the Aged, Humans, Life Expectancy, Liver Function Tests, Longitudinal Studies, Male, Mental Status Schedule, Middle Aged, Neuropsychological Tests, Nursing Homes, Patient Admission, Prognosis, Psychometrics, Tacrine, Survival Analysis, Treatment Outcome, Outcome Assessment, Health Care, Chemical and Drug Induced Liver Injury
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