Efficacy of Donepezil on Maintenance of Activities of Daily Living in Patients with Moderate to Severe Alzheimer's Disease and the Effect on Caregiver Burden

Abstract

Donepezil demonstrated a significantly slower decline than placebo in instrumental and basic ADLs in these patients with moderate to severe AD. The ADL benefits in AD patients treated with donepezil were associated with less caregiving time and lower levels of caregiver stress.

Assessment of physical function and participation in chronic pain clinical trials: IMMPACT/OMERACT recommendations

“…As previously described, a number of measures can be used to assess the impact of pain on work functioning, within and There are a number of tools to measure caregiver burden. 50,58,75,89,100,125,167 However, to date this concept has not received sufficient attention, especially in the field of pain. Caregiver burden has been included as an outcome measure in phase 3 clinical trials in Alzheimer's disease, the index condition for studying caregiver burden 29 , and such measures may have a role in later-phase pain clinical trials.…”

Guidelines for the Management of Cognitive and Behavioral Problems in Dementia

“…28 Significant preservation of ADL function has been observed with donepezil, galantamine, and rivastigmine compared with placebo. 29 ChEIs also have been shown to reduce AD caregiver burden: in patients with moderate to severe 44 A small study has demonstrated that rivastigmine treatment reduces caregiver time spent assisting with ADLs (up to 690 hours over 2 years). 45 Longer periods of treatment with ChEIs also decrease the risk for nursing home placement.…”

A Systematic Review of Assessment and Treatment of Moderate to Severe Alzheimer's Disease

“…33 These scales have been modified to enhance their sensitivity for use in clinical trials of moderate to severe AD (IADL+ and PSMS+). 3,41 As reported by Feldman et al, 41 these modified instruments are sufficiently sensitive to measure drug treatment effects in moderate to severe AD patients; however, notable limitations of these scales include coarse rating increments that impede their sensitivity to change and the need for concurrent use of both scales to obtain information on basic and instrumental ADLs. 46 Other limitations of these and other available assessments of function include the use of gender-specific items, subjective questioning, and inclusion of behavioral as well as functional information.…”

“…41 Additional benefits of the delayed functional decline seen with donepezil treatment included less time spent in provision of care and lower levels of caregiver stress, thus extending the effects of donepezil in moderate to severe patients to include measurable effects on caregivers.…”