Donepezil for mild cognitive impairment

Birks, Jacqueline; Flicker, Leon

doi:10.1002/14651858.cd006104

Cited by 122 publications

(80 citation statements)

References 16 publications

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“…At present, the literature does not provide sufficient evidence to make recommendations for interventions targeting adults aged 60 years and older. For example, despite some transient benefits, prevention trials indicate no effect of cholinesterase inhibitors in delaying the onset of dementia in older adults [31,32,33]. However, the present study suggests that engaging in cognitive activity later in life is relatively effective, particularly in older adults above the age of 60 years.…”

Section: Discussionmentioning

confidence: 50%

Effects of a Multidomain Lifestyle Modification on Cognitive Function in Older Adults: An Eighteen-Month Community-Based Cluster Randomized Controlled Trial

Lee

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et al. 2014

Psychother Psychosom

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Background: A healthy lifestyle may protect against cognitive decline. We examined outcomes in elderly individuals after 18 months of a five-group intervention program consisting of various modalities to prevent cognitive decline. Methods: We conducted a cluster randomized controlled trial assessing 460 community-dwelling individuals aged 60 years and older in a geriatric community mental health center in Suwon, Republic of Korea, between 2008 and 2010. We developed an intervention program based on the principles of contingency management, which could be delivered by ordinary primary health workers. Group A (n = 81) received standard care services. Group B (n = 80) received bimonthly (once every 2 months) telephonic care management. Group C (n = 111) received monthly telephonic care management and educational materials similar to those in group B. Group D (n = 93) received bimonthly health worker-initiated visits and counseling. Group E (n = 94) received bimonthly health worker-initiated visits, counseling, and rewards for adherence to the program. Results: The primary outcome was the change in Mini-Mental State Examination (MMSE) scores from baseline to the final follow-up visit at 18 months. Group E showed superior cognitive function to group A (adjusted coefficient β = 0.99, p = 0.044), with participation in cognitive activities being the most important determining factor among several health behaviors (adjusted coefficient β = 1.04, p < 0.01). Conclusions: Engaging in cognitive activities, in combination with positive health behaviors, may be most beneficial in preserving cognitive abilities in community-dwelling older adults.

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Section: Discussionmentioning

confidence: 50%

Effects of a Multidomain Lifestyle Modification on Cognitive Function in Older Adults: An Eighteen-Month Community-Based Cluster Randomized Controlled Trial

Lee

Back

et al. 2014

Psychother Psychosom

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“…11,38 Neither of those reviews found any significant improvements in cognition, and both reviews found significantly more harms associated with these agents. The most recent Cochrane review included 9 studies, 11 3 of which were excluded from our review because they included mixed patient populations with vascular dementia 39,40 or did not include our outcomes of interest.…”

Section: Discussionmentioning

confidence: 96%

Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: a systematic review and meta-analysis

Tricco

Soobiah

Berliner

et al. 2013

CMAJ

176

117

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O lder adults experiencing memory and cognition deficits without substantial limitations in activities of daily living may be given a diagnosis of mild cognitive impairment.1 These patients often present with subjective memory loss, impairment of cognitive function and no change in their basic daily functioning. Mild cognitive impairment has recently been recognized as a distinct condition, with a prevalence that ranges from 3% to 42% and increases with age.2 Because of the growing proportion of older adults worldwide, the prevalence of this condition will only increase in the future.3 Each year, 3%-17% of people with mild cognitive impairment experience progression to dementia, 4-6 a rate that increases to between 11% and 33% by 2 years after the initial diagnosis.7 More than 4.6 million new cases of dementia are diagnosed each year, 3 and efforts to reduce this public health burden are essential. Strategies to delay the progression of mild cognitive impairment are being sought to meet this challenge.One strategy that has been hypothesized to delay the progression from mild cognitive impairment to dementia is the use of cognitive enhancers, agents that are often used to treat dementia. These medications include cholinesterase inhibitors (e.g., donepezil, rivastigmine and galantamine) and the N-methyl-d-aspartic acid receptor antagonist memantine.8 donepezil, rivastigmine and galantamine increase the concentration of acetylcholine at neurotransmitter sites, 9 enhancing the brain's cholinergic function. Galantamine also influences activity at nicotinic receptors, 9 whereas memantine modulates the neurotransmitter glutamate. We conducted a systematic review to examine the efficacy and safety of cognitive enhancers for mild cognitive impairment.

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“…A recent Cochrane review suggests that MCI patients should not be treated with the cholinesterase inhibitor donepezil [26]. Donepezil treatment has been associated with a lower rate of progression to AD during the first year of treatment but has not been proven to impact the rate of progression at 3 years [27].…”

Section: Mild Cognitive Impairmentmentioning

confidence: 99%

Dementia syndromes: evaluation and treatment

Scott

Barrett

2007

Expert Review of Neurotherapeutics

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As our population ages, diseases affecting memory and daily functioning will affect an increasing number of individuals, their families and the healthcare system. The social, financial and economic impacts will be profound. This article provides an overview of current dementia syndromes to assist clinicians in evaluating, educating and treating these patients. KeywordsAlzheimer's disease; cognition; dementia; donepezil; galantamine; memory; rivastigmine; vascular dementia Dementia is a progressive disorder of memory loss and impaired cognitive ability. The Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV defines dementia as a decline in memory with impairment of at least one other cognitive function, such as skilled movements (limb apraxia), language (aphasia) or executive function (e.g., planning, attention and abstract reasoning). This decline should represent a change from previous behavior; it should impair social and/or occupational functioning; and cannot be accounted for by other psychiatric conditions such as depression, other mood disorders or psychosis [1,2].Dementia comes in many forms, with the Alzheimer's and vascular subtypes being most common [3]. Dementia (neurodegenerative) is age related, with prevalence estimated at 20% in individuals older than 85 years [201]. The decline in cognition and memory function not only affects test performance, but often manifests as behavioral and mood changes, as well as the inability to perform activities of daily living (ADLs). With our aging population, the number of patients with dementia will rise and place an increasing burden on families and our healthcare system. Accurate diagnosis of dementia is important for prognosis and to guide therapy. The number of potentially reversible dementias, perhaps upwards of 11%, is small, but these disorders may †

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Donepezil for mild cognitive impairment

Cited by 122 publications

References 16 publications

Effects of a Multidomain Lifestyle Modification on Cognitive Function in Older Adults: An Eighteen-Month Community-Based Cluster Randomized Controlled Trial

Effects of a Multidomain Lifestyle Modification on Cognitive Function in Older Adults: An Eighteen-Month Community-Based Cluster Randomized Controlled Trial

Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: a systematic review and meta-analysis

Dementia syndromes: evaluation and treatment

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