Long-Term Use of Rivastigmine in Patients With Dementia With Lewy Bodies: An Open-Label Trial

2001 ◽  
Vol 13 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Janet Grace ◽  
Sarah Daniel ◽  
Timothy Stevens ◽  
K. K. Shankar ◽  
Zuzanna Walker ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Mini Mental State Examination ◽  
Neuropsychiatric Symptoms ◽  
Lewy Bodies ◽  
Neuropsychiatric Inventory ◽  
Short Term ◽  
Open Label ◽  
Open Label Trial ◽  
State Examination

Patients with dementia with lewy bodies (DLB) have progressive deficits in cognition, parkinsonism, and neuropsychiatric symptoms. Cholinesterase inhibitors have been used to ameliorate cognitive decline and neuropsychiatric symptoms in short-term trials. In this study, patients with DLB were treated with rivastigmine up to 96 weeks. Improvement from baseline was seen in cognitive function as measured by the Mini-Mental State Examination (MMSE), and neuropsychiatric symptoms as measured by the Neuropsychiatric Inventory (NPI) over the first 24 weeks of treatment. By 96 weeks, neither the MMSE scores nor the NPI scores were significantly worse than at baseline.

Dementia With Lewy Bodies Treated With Rivastigmine: Effects on Cognition, Neuropsychiatric Symptoms, and Sleep

2001 ◽  
Vol 13 (3) ◽  
pp. 277-288 ◽  
Author(s):  
Lara E. Maclean ◽  
Chris C. Collins ◽  
E. Jane Byrne
Keyword(s):  
Dementia With Lewy Bodies ◽  
Mini Mental State Examination ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Case Series ◽  
Lewy Bodies ◽  
Symptomatic Treatment ◽  
Additional Information ◽  
Dementia Syndrome ◽  
State Examination

Dementia with Lewy bodies (DLB) is a common cause of the dementia syndrome. Symptomatic treatment of the fluctuating cognition, visual hallucinations, and sleep distrubance that characterize this condition is challenging; neuroleptics are relatively contraindicated. We describe eight patients fulfilling the consensus diagnostic criteria for probable DLB who were treated with rivastigmine. Clinical features rated were: cognition by the Modified Mini-Mental State Examination (3MS); and behavioral and psychiatric symptoms by the Neuropsychiatric Inventory (NPI). Additional information was obtained from family and nursing reports. Seven patients showed resolution or improvement in cognition and neuropsychiatric symptoms as demonstrated by improvement in their 3MS and NPI scores. They also became more independent in mobility and activities of daily living, and the majority returned to live in their own home. Of the seven patients with sleep disruption, six improved. One case had no improvement in his symptomatology and the rivastigmine was stopped. Outcomes in this case series suggest that rivastigmine is well tolerated in clinical practice.

scholarly journals Effects of Donepezil on Extrapyramidal Symptoms in Patients with Dementia with Lewy Bodies: A Secondary Pooled Analysis of Two Randomized-Controlled and Two Open-Label Long-Term Extension Studies

2015 ◽  
Vol 40 (3-4) ◽  
pp. 186-198 ◽  
Author(s):  
Etsuro Mori ◽  
Manabu Ikeda ◽  
Masaki Nakagawa ◽  
Hideaki Miyagishi ◽  
Hideo Yamaguchi ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Rating Scale ◽  
Multivariate Logistic Regression Analysis ◽  
Lewy Bodies ◽  
Pooled Analysis ◽  
Extrapyramidal Symptoms ◽  
Open Label ◽  
Predisposing Factor ◽  
Baseline Severity

Background/Aims: The aim of this study was to clarify the effects of donepezil on extrapyramidal symptoms in patients with dementia with Lewy bodies (DLB). Methods: Using pooled datasets from phase 2 and 3, 12-week randomized, placebo-controlled trials (RCT, n = 281) and 52-week open-label long-term extension trials (OLE, n = 241) of donepezil in DLB, the effects of donepezil on the incidence of extrapyramidal adverse events (AEs) and on the Unified Parkinson's Disease Rating Scale (UPDRS) part III were assessed, and potential baseline factors affecting the AEs were explored. Results: The RCT analysis did not show significant differences between the placebo and active (3, 5, and 10 mg donepezil) groups in extrapyramidal AE incidence (3.8 and 6.5%, p = 0.569) and change in the UPDRS (mean ± SD: -0.2 ± 4.3 and -0.6 ± 6.5, p = 0.562). In the OLE analysis (5 and 10 mg donepezil), the incidence did not increase chronologically; all AEs leading to a dose reduction or discontinuation except one were relieved. The UPDRS was unchanged for 52 weeks. An exploratory multivariate logistic regression analysis of the RCTs revealed that donepezil treatment was not a significant factor affecting the AEs. Baseline severity of parkinsonism was a predisposing factor for worsening of parkinsonism without significant interactions between donepezil and baseline severity. Conclusion: DLB can safely be treated with donepezil without relevant worsening of extrapyramidal symptoms, but treatment requires careful attention to symptom progression when administered to patients with relatively severe parkinsonism.

Acute Psychogeriatric Inpatient Treatment Improves Neuropsychiatric Symptoms but Impairs the Level of Functioning in Patients with Dementia

2015 ◽  
Vol 40 (5-6) ◽  
pp. 290-296 ◽  
Author(s):  
Hanna-Mari Alanen ◽  
Anneli Pitkänen ◽  
Kirsti Suontaka-Jamalainen ◽  
Olli Kampman ◽  
Esa Leinonen
Keyword(s):  
Mental State ◽  
Daily Living ◽  
Mini Mental State Examination ◽  
Neuropsychiatric Symptoms ◽  
Functional Decline ◽  
Neuropsychiatric Inventory ◽  
Behavioral Disturbances ◽  
Level Of Functioning ◽  
The Impact ◽  
State Examination

Aims: To explore the impact of hospitalization on neuropsychiatric symptoms (NPS) and the level of functioning in patients with dementia. Our aim was also to study the influence of psychotropic medications. Methods: Behavioral disturbances, cognition and functional status of 89 patients were assessed using the Neuropsychiatric Inventory (NPI), Mini-Mental State Examination, Barthel Index, and Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCSADL). Results: The total NPI score decreased from 34.6 to 19.5 (p < 0.001), and ADL decreased from 32.2 to 21.7 (p < 0.001) during the hospital stay (mean of 44 days). For a change in ADL, only the effect of anxiolytics was significant (p = 0.045). For a change in NPI with antipsychotic and anxiolytic doses and Mini-Mental State Examination as covariates, no significant relationship was found. Conclusion: NPS improved significantly during hospitalization, but neither antipsychotic nor anxiolytic medication use explained this improvement. In patients using anxiolytics, the functional decline was substantial. These results do not support anxiolytic use in demented patients with NPS.

scholarly journals Long-term donepezil use for dementia with Lewy bodies: results from an open-label extension of Phase III trial

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Etsuro Mori ◽  
Manabu Ikeda ◽  
Reiko Nagai ◽  
Kazutaka Matsuo ◽  
Masaki Nakagawa ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Phase Iii ◽  
Open Label ◽  
Phase Iii Trial ◽  
Open Label Extension

scholarly journals Genetics Contributes to Concomitant Pathology and Clinical Presentation in Dementia with Lewy Bodies

2021 ◽  
pp. 1-11
Author(s):  
Sven J. van der Lee ◽  
Inger van Steenoven ◽  
Marleen van de Beek ◽  
Niccolo Tési ◽  
Iris E. Jansen ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Mini Mental State Examination ◽  
Disease Duration ◽  
Age At Onset ◽  
Lewy Bodies ◽  
Risk Scores ◽  
Clinical Measures ◽  
Core Symptoms ◽  
State Examination

Background: Dementia with Lewy bodies (DLB) is a complex, progressive neurodegenerative disease with considerable phenotypic, pathological, and genetic heterogeneity. Objective: We tested if genetic variants in part explain the heterogeneity in DLB. Methods: We tested the effects of variants previously associated with DLB (near APOE, GBA, and SNCA) and polygenic risk scores for Alzheimer’s disease (AD-PRS) and Parkinson’s disease (PD-PRS). We studied 190 probable DLB patients from the Alzheimer’s dementia Cohort and compared them to 2,552 control subjects. The p-tau/Aβ 1–42 ratio in cerebrospinal fluid was used as in vivo proxy to separate DLB cases into DLB with concomitant AD pathology (DLB-AD) or DLB without AD (DLB-pure). We studied the clinical measures age, Mini-Mental State Examination (MMSE), and the presence of core symptoms at diagnosis and disease duration. Results: We found that all studied genetic factors significantly associated with DLB risk (all-DLB). Second, we stratified the DLB patients by the presence of concomitant AD pathology and found that APOE ɛ4 and the AD-PRS associated specifically with DLB-AD, but less with DLB-pure. In addition, the GBA p.E365K variant showed strong associated with DLB-pure and less with DLB-AD. Last, we studied the clinical measures and found that APOE ɛ4 associated with reduced MMSE, higher odds to have fluctuations and a shorter disease duration. In addition, the GBA p.E365K variant reduced the age at onset by 5.7 years, but the other variants and the PRS did not associate with clinical features. Conclusion: These finding increase our understanding of the pathological and clinical heterogeneity in DLB.

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