Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial

Devanand, Davangere P.; Pelton, Gregory H.; D’Antonio, Kristina; Ciarleglio, Adam; Scodes, Jennifer; Andrews, Howard; Lunsford, Julia; Beyer, John L.; Petrella, Jeffrey R.; Sneed, Joel R.; Ciovacco, Michaela; Doraiswamy, P. Murali

doi:10.1016/j.jagp.2018.05.008

Cited by 37 publications

(28 citation statements)

References 42 publications

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“…5,6 Moreover, cognitive enhancers only have a modest and inconsistent effect on cognitive decline in this population. 7,8 One study assessed the combination of donepezil with standard antidepressant maintenance in preventing cognitive decline in older patients with remitted MDD. 7 The addition of donepezil had a modest and temporary (one-year) effect on global cognition but it was associated with a higher rate of depressive relapse (35%) than placebo (19%).…”

Section: Introductionmentioning

confidence: 99%

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Effects of bilateral transcranial direct current stimulation on working memory and global cognition in older patients with remitted major depression: A pilot randomized clinical trial

Kumar

Batist

Ghazala

et al. 2020

Int J Geriat Psychiatry

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Objectives To assess the effects of a 10‐day course of bilateral anodal transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) on working memory and global cognition in elderly participants with remitted major depressive disorder at 14 days (primary outcome) and 90 days (secondary outcome) post intervention. Design Randomized double blind controlled trial (http://clinicaltrials.gov # NCT02212366). Setting Community dwelling outpatient setting. Participants Sixty or older with previous single or recurrent episodes of major depression currently in full remission. Intervention A 10 day course of active or sham bilateral DLPFC anodal tDCS. Measurements (a) Working memory assessed by a computerized N back task, and (b) global cognition assessed by a standard paper and pencil neuropsychological test battery. Results Thirty‐three participants, (mean (SD) age = 66. 5 (5.7) year) were enrolled, out of which 18 (mean (SD) age = 66. 3 (5.8) year) were randomized to active tDCS and 15 (mean (SD) age = 66. 7 (5.8) years) to sham tDCS. All randomized participants except one from the sham group ‐completed the tDCS course. There were no differences between the groups on working memory performance or global cognition at 14 or 90 days post intervention. Both groups showed promising changes in working memory and global cognition over time. Conclusions tDCS was well tolerated in older patients with remitted MDD, however, as compared to the sham group, it did not improve working memory or global cognition. Future studies should investigate tDCS with alternative parameters to enhance cognition in this population.

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Section: Introductionmentioning

confidence: 99%

“…7 In another study, donepezil did not show any cognitive benefits in patients with depression and mild cognitive impairment (MCI). 8 Thus, there is a need for interventions that slow or prevent cognitive decline in older patients with MDD.…”

Section: Introductionmentioning

confidence: 99%

Effects of bilateral transcranial direct current stimulation on working memory and global cognition in older patients with remitted major depression: A pilot randomized clinical trial

Kumar

Batist

Ghazala

et al. 2020

Int J Geriat Psychiatry

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“…Similar to our results in the current study, depression was found to be common among patients with MCI and cognitive de cits [25], placing those patients at higher risk for dementia in their later years. This combination of depression and MCI complicates the health condition of these patients at later stages of life, particularly affecting their treatment for combating cognitive decline, such as donepezil for Alzheimer's disease as reported by Devanand and colleagues [26].…”

Section: Discussionmentioning

confidence: 97%

Factors Influencing the Deterioration from Cognitive Decline of Normal Aging to Dementia among Nursing Home Residents

Hayajneh

Rababa

Alghwiri

et al. 2020

Preprint

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Background: A dearth of differential research exists regarding the determinants of mild cognitive impairment (MCI) and moderate cognitive impairment or dementia among nursing home residents. This study aimed to identify and examine the factors that lead to progression of MCI to moderate cognitive impairment or dementia in nursing home residents.Methods: A cross-sectional design was used in this study. Convenience sampling of 182 participants was conducted in nursing homes located in the central part of Jordan. Montreal cognitive assessment (MoCA) was used to screen both MCI and moderate cognitive impairment or dementia. Bivariate analysis, including t-test and ANOVA test, and logistic and linear regression models were used to examine and identify the predictors of dementia.Results: Most nursing home residents had MCI (87.4%) compared to a few with moderate cognitive impairment or dementia. Age (t = -2.773), number of comorbidities (t = -4.045), depression (t = -4.809), frailty (t = -4.038), and quality of life physical (t = 3.282) and mental component summaries (t = 2.469) were significantly different between the stages of cognitive impairment. Marital status (t = -4.050, p < 0.001), higher-income (t = 3.755, p < 0.001), recent hospitalization (t = 2.622,p = 0.01), depression (t = -2.737, p = 0.007), and frailty (t = 2.852, p = 0.005) were significantly associated with mental ability scores among nursing home residents.Conclusion: The coexistence of comorbidities and depression among nursing home residents with MCI necessitates prompt management by healthcare providers to combat depressive symptoms in order to delay the dementia trajectory among at-risk residents.

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“…Similar to our results in the current study, depression was found to be common among patients with MCI and cognitive de cits [30], placing those patients at higher risk for dementia in their later years. This combination of depression and MCI complicates the health condition of these patients at later stages of life, particularly affecting their treatment for combating cognitive decline, such as donepezil for Alzheimer's disease as reported by Devanand and colleagues [31].…”

Section: Discussionmentioning

confidence: 97%

Factors Influencing the Deterioration from Cognitive Decline of Normal Aging to Dementia among Nursing Home Residents

Hayajneh

Rababa

Alghwiri

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: A dearth of differential research exists regarding the determinants of mild cognitive impairment (MCI) and moderate cognitive impairment or dementia among nursing home residents. This study aimed to identify and examine the association between medical factors (number of comorbidities, hospitalization, disability, depression, frailty and quality of life) and moderate cognitive impairment or dementia in nursing homes residents.Methods: A cross-sectional design was used in this study. Convenience sampling of 182 participants was conducted in nursing homes located in the central part of Jordan. Montreal cognitive assessment (MoCA) was used to screen both MCI and moderate cognitive impairment or dementia. Bivariate analysis, including t-test and ANOVA test, and logistic and linear regression models were used to examine and identify the medical factors associated with moderate cognitive impairment or dementia compared to mild cognitive impairment.Results: Most nursing home residents had MCI (87.4%) compared to a few with moderate cognitive impairment or dementia. Age (t = -2.773), number of comorbidities (t = -4.045), depression (t = -4.809), frailty (t = -4.038), and quality of life physical (t = 3.282) and mental component summaries (t = 2.469) were significantly different between the stages of cognitive impairment. Marital status (t = -4.050, p < 0.001), higher-income (t = 3.755, p < 0.001), recent hospitalization (t = 2.622,p = 0.01), depression (t = -2.737, p = 0.007), and frailty (t = 2.852, p = 0.005) were significantly associated with mental ability scores among nursing home residents.Conclusion: The coexistence of comorbidities and depression among nursing home residents with MCI necessitates prompt management by healthcare providers to combat depressive symptoms in order to delay the dementia trajectory among at-risk residents. Trail registration: ClinicalTrials.gov NCT04589637, October 15,2020, Retrospectively registered.

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Donepezil Treatment in Patients With Depression and Cognitive Impairment on Stable Antidepressant Treatment: A Randomized Controlled Trial

Abstract: The results do not support adjunctive off-label cholinesterase inhibitor treatment in patients with depression and cognitive impairment. The findings highlight the need to prioritize discovery of novel treatments for this highly prevalent population with comorbid illnesses.

Cited by 37 publications

References 42 publications

Effects of bilateral transcranial direct current stimulation on working memory and global cognition in older patients with remitted major depression: A pilot randomized clinical trial

Effects of bilateral transcranial direct current stimulation on working memory and global cognition in older patients with remitted major depression: A pilot randomized clinical trial

Factors Influencing the Deterioration from Cognitive Decline of Normal Aging to Dementia among Nursing Home Residents

Factors Influencing the Deterioration from Cognitive Decline of Normal Aging to Dementia among Nursing Home Residents

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