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Acetylcholinesterase inhibitors and depressive symptoms in patients with mild to moderate Alzheimer’s Disease

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Abstract

Background and aims: Acetilcholinesterase inhibitor (AChEis) therapy in Alzheimer Disease (AD) has been shown to provide cognitive benefits and to slow progression of the disease. AChEis have also been demonstrated to improve behavioral symptoms, although there seem to be subtle differences in the magnitude of response. The aim of our study was to evaluate the effect of 16 weeks treatment with AChEis on depressive symptoms in a selected sample of AD patients in routine clinical practice. Subjects and methods: A study of 135 patients with Alzheimer’s disease. All subjects were assessed at baseline (upon initiation of AChEis therapy) and re-evaluated after 16 weeks. Results: At baseline, «Depressed» and «Not depressed» patients were categorized according to DSM IV criteria for depression in Alzheimer Disease. After 16 weeks of treatment with AchEis, we observed an improvement of mood in the “Depressed” patients. In this group “Mood symptoms”, measured with GDS, were independently associated with GDS “Mood symptoms” at baseline, but not with improvement on cognition (mean change of MMSE), age or sex. Conclusions: In depressed AD subjects, AChEis treatment improves depressive symptoms evaluated by GDS. This improvement is independent of cognition enhancement.

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References

  1. Rabins PV, Lyketsos CG, Steele CD. Practical Dementia Care. New York, Oxford University Press, 1999.

    Google Scholar 

  2. Lyketsos CG, Steele C, Steinberg M. Behavioral disturbances in dementia. In Gallo JJ, Busby-Whitehead J, Rabins PV, Silliman RA, Murphy JB, Reichel W, Eds. Baltimore: Williams & Wilkins: Reichel’s Care of the Elderly: Clinical Aspects of Aging, 1999; 214–28.

  3. Chen P, Ganguli M, Mulsant BH, et al. The temporal relationship between depressive symptoms and dementia. Arch Gen Psychiatry 1999; 56: 261–6.

    Article  PubMed  CAS  Google Scholar 

  4. Comijs HC, van Tilburg T, Geerlings SW, et al. Do severity and duration of depressive symptoms predict cognitive decline in older persons? Results of the Longitudinal Aging Study Amsterdam. Aging Clin Exp Res. 2004; 16: 226–32.

    PubMed  Google Scholar 

  5. Rogers SL, Farlow MR, Doody RS, et al. A 24-week, double-blind, placebo-controlled trial of denepezil in patients with Alzheimer’s disease. Donepezil Study Group. Neurology 1998; 50: 136–45.

    CAS  Google Scholar 

  6. Corey-Bloom J, Anand R, Veach J. A randomized trial evaluating the efficacy and safety of ENA 713 (rivastigmine tartrate), a new acetylcholinesterase inhibitor, in patients with mild to moderately severe Alzheimer’s disease, for the ENA 713 B352 Study Group. Int J Geriatr Psychopharmacol 1998; 1: 55–65.

    CAS  Google Scholar 

  7. Wilcock GK, Lilienfeld S, Gaens E. Efficacy and safety of galantamine in patients with mild to moderate Alzheimer’s disease: multicentre randomized controlled trial. Galantamine International-1 Study Group. BMJ 2000; 321: 1445–9.

    CAS  Google Scholar 

  8. Rogers SL, Doody RS, Pratt RD, Ieni JR. Long-term efficacy and safety of donepezil in the treatment of Alzheimer’s disease: final analysis of a US multicentre open-label study. Eur Neuropsyhcopharmacol 2000; 10: 195–203.

    Article  CAS  Google Scholar 

  9. Mega MS, Masterman DM, O’Connor SM, Barclay TR, Cummings JL. The spectrum of behavioral responses to cholinesterase inhibitor therapy in Alzheimer Disease. Arch Neurol. 1999; 56: 1388–93.

    Article  PubMed  CAS  Google Scholar 

  10. Cummings JL, Masterman DL. Efficacy of metrifonate in improving the psychiatric and behavioral disturbances of patients with Alzheimer’s disease. J Clin Psychiatry 1998; 59(Suppl 13): 23–30.

    PubMed  Google Scholar 

  11. Cummings JL, Nadel A, Masterman D, Cyrus PA. Galantamine for Alzheimer’s disease. J Geriatr Psychiatry Neurol 2001; 14: 101–8.

    Article  PubMed  CAS  Google Scholar 

  12. Rosler M, Retz W, Retz-Junginger P, Dennler HJ. Effects of two-year treatment with the cholinesterase inhibitor rivastigmine on behavioral symptoms in Alzheimer’s disease. Behav Neurol 1998; 11: 211–6.

    PubMed  Google Scholar 

  13. Bellelli G, Lucchi E, Minicuci N, et al. Results of a multi-level therapeutic approach for Alzheimer’s disease subjects in the “real world” (CRONOS project): a 36-week follow-up study. Aging Clin Exp Res. 2005; 17: 54–61.

    PubMed  Google Scholar 

  14. Frisoni GB, Galluzzi S, Riello R. Prescription and choice of diagnostic imaging by physician specialty in Alzheimer’s Centers (Unità di Valutazione Alzheimer — UVA) in Northern Italy. Aging Clin Exp Res 2005; 17: 14–9.

    PubMed  Google Scholar 

  15. McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34: 939–44.

    Article  PubMed  CAS  Google Scholar 

  16. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.

    CAS  Google Scholar 

  17. Arbus C, Andrieu S, Amouyal-Barkate K, Nourhashemi F, Schmitt L, Vellas B. Depressive symptoms in Alzheimer’s disease: preliminary results of the REAL.FR study. Rev Med Interne 2003; 24(Suppl 3): 325s-32s.

    Article  Google Scholar 

  18. Cummings JL, Mega MS, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14.

    Article  PubMed  CAS  Google Scholar 

  19. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, American Psychiatric Association, 1994.

    Google Scholar 

  20. Gleason CE, Baker LD, Cholerton BA, et al. Depression symptoms associated with cognitive impairment: Is it really depression? Neurobiol Aging 2000: 21(Suppl. 1): s237.1

    Article  Google Scholar 

  21. Statistical Package for the Social Sciences for Windows, release 11.5.1 (Italian version). Chicago (IL): SPSS Inc.; 2002.

  22. Knapp MJ, Knopman DS, Solomon PR et al. A 30-week randomized controlled trial of high-dose tacrine in patients with Alzheimer’s disease. The Tacrine Study Group. JAMA 1994; 6; 271: 985–91.

    CAS  Google Scholar 

  23. Cummings JL, Thomas MR, Zhang R, et al. The Donepezil-Sertraline Study Group Effects of Donepezil on Neuropsychiatric Symptoms in Patients With Dementia and Severe Behavioral Disorders. Am J Geriatr Psychiatry 2006; 7: 605–12.

    Article  Google Scholar 

  24. Trinh NH, Hoblyn J, Mohanty S, Yaffe K. Efficacy of cholinesterase inhibitors in the treatment of neuropsychiatric symptoms and functional impairment in Alzheimer disease: a meta-analysis. JAMA 2003; 289: 210–6.

    Article  PubMed  CAS  Google Scholar 

  25. Feldman H, Gauthier S, Hecker J, et al. Donepezil MSAD Study Investigators Group. 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. J Am Geriatr Soc 2003; 51: 737–44.

    Google Scholar 

  26. Kaufer DI, Cummings JL, Christine D. Effect of tacrine on behavioral symptoms in Alzheimer’s disease: an open-label study. J Geriatr Psychiatry Neurol 1996; 9: 1–6.

    PubMed  CAS  Google Scholar 

  27. Wilson RS, Schneider JA, Bienias JL, et al. Depressive symptoms, clinical AD, and cortical plaques and tangles in older persons. Neurology 2003; 61: 1102–7.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of Brescia, Italy

    Luca Rozzini MD, Barbara Vicini Chilovi, Erik Bertoletti & Alessandro Padovani

  2. Geriatric Research Group, Brescia, Italy

    Luca Rozzini MD, Barbara Vicini Chilovi & Marco Trabucchi

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  1. Luca Rozzini MD
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  2. Barbara Vicini Chilovi
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  3. Erik Bertoletti
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  4. Marco Trabucchi
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  5. Alessandro Padovani
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Correspondence to Luca Rozzini MD.

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Rozzini, L., Chilovi, B.V., Bertoletti, E. et al. Acetylcholinesterase inhibitors and depressive symptoms in patients with mild to moderate Alzheimer’s Disease. Aging Clin Exp Res 19, 220–223 (2007). https://doi.org/10.1007/BF03324693

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