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Clinical predictors of response to Acetyl Cholinesterase Inhibitors: experience from routine clinical use in Newcastle

Lookup NU author(s): Dr Sanjeet Pakrasi, Dr Elizabeta Mukaetova-Ladinska, Professor Ian McKeith, Professor John O'Brien

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Abstract

Background Acetyl Cholinesterase Inhibitors (AChEIs) have been in clinical use for the past five years in the UK for the symptomatic treatment of Alzheimer's disease (AD). There are few data on the patterns and predictors of response to AChEI therapy in routine clinical practice. We therefore investigated clinical variables that may distinguish between AChEI responders and non-responders. Methods A retrospective sample of 160 consecutive patients with dementia who were treated on clinical grounds with an AChEI was studied. Treatment response was defined in two ways: (a) A clinical response was achieved when there was no deterioration or there was an improvement on a global clinical assessment (CGI) and (b) a Mini-Mental-State-Examination (MMSE) response when there was an improvement of 2 or more MMSE points. Results A total of 62 (45%) patients achieved an MMSE response. A diagnosis of dementia with Lewy Bodies (DLB) and Parkinson's disease + Dementia (PDD) was associated with a MMSE response, as were hallucinations, and lower MMSE scores at baseline. 125 (78%) patients achieved a CGI response for which there were no clinical predictors. Conclusions Severity of illness, a diagnosis of DLB and PDD, and presence of hallucinations at baseline were predictive of a MMSE response. Non-AD dementia and severe dementia responded equally well to AChEI treatment and results of further randomised, placebo-controlled studies are needed to clarify the role of AChEI in the treatment of these disorders. Copyright (C) 2003 John Wiley Sons, Ltd.


Publication metadata

Author(s): Mukaetova-Ladinska EB; McKeith IG; O'Brien JT; Pakrasi S

Publication type: Article

Publication status: Published

Journal: International Journal of Geriatric Psychiatry

Year: 2003

Volume: 18

Issue: 10

Pages: 879-886

ISSN (print): 0885-6230

ISSN (electronic): 1099-1166

Publisher: John Wiley & Sons Ltd

URL: http://dx.doi.org/10.1002/gps.928

DOI: 10.1002/gps.928


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