Good rate of clinical response to cholinesterase inhibitors in mild and moderate Alzheimer's disease after three months of treatment: An open-label study.
Life expectancy in Brazil has increased markedly over the last 30 years. Hence, age-related disorders, such as Alzheimer's disease (AD), warrant special attention due to their high prevalence in the elderly. Pharmacologic treatment of AD is based on cholinesterase inhibitors (ChEI) and memantine, leading to modest clinical benefits both in the short and long-term. However, clinical response is heterogeneous and needs further investigation.


OBJECTIVE
To investigate the rate of response to ChEI in AD after three months of treatment.


METHODS
Patients with mild or moderate dementia due to probable AD or to AD associated with cerebrovascular disease were included in the study. The subjects were assessed at baseline and again after three months of ChEI treatment. Subjects were submitted to the Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, Katz Basic Activities of Daily Living, Pfeffer Functional Activities Questionnaire, Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Good response was defined by a gain of ≥2 points on the MMSE after three months of treatment in relation to baseline.


RESULTS
Seventy-one patients, 66 (93%) with probable AD and five (7%) with AD associated with cerebrovascular disease, were evaluated. The good response rate at three months was 31.0%, being 37.2% and 21.4% in mild and moderate dementia, respectively. There were no significant differences on most tests, except for improvement in hallucinations, agitation and dysphoria in moderate dementia patients.


CONCLUSION
The rate of good clinical response to ChEI was higher than usually reported. Specific behavioral features significantly improved in the subgroup of moderate dementia.
['de Miranda|Luis Felipe José Ravic|LFJR|', 'Barbosa|Marilourdes do Amaral|MDA|', 'Peles|Patrícia Regina Henrique|PRH|', 'Pôças|Patrícia Hilar|PH|', 'Tito|Pedro Augusto Lopes|PAL|', 'Matoso|Rafael de Oliveira|RO|', 'de Lima|Thiago Oliveira Lemos|TOL|', 'de Moraes|Edgar Nunes|EN|', 'Caramelli|Paulo|P|']
cholinesterase inhibitors treatment open-label Alzheimer disease clinical trial