Alzheimer's & Dementia: The Journal of the Alzheimer's Association
Volume 6, Issue 6 , Pages 431-439, November 2010

Predicting cognitive decline in Alzheimer's disease: An integrated analysis

  • Oscar L. Lopez

      Affiliations

    • Department of Neurology, Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
    • Department of Psychiatry, Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA
    • Corresponding Author InformationCorresponding author: Tel.: (724) 935-1500.
    • ,
  • Elias Schwam

      Affiliations

    • Pfizer Global Pharmaceuticals, Pfizer Inc, New York, NY, USA
    • ,
  • Jeffrey Cummings

      Affiliations

    • Mary S. Easton Center for Alzheimer's Disease Research, UCLA, Los Angeles, CA, USA
    • ,
  • Serge Gauthier

      Affiliations

    • McGill Center for Studies in Aging, Douglas Mental Health University Institute, Douglas Hospital, Verdun, Quebec, Canada
    • ,
  • Roy Jones

      Affiliations

    • RICE (Research Institute for the Care of Older People), Royal United Hospital, Bath, United Kingdom
    • ,
  • David Wilkinson

      Affiliations

    • Memory Assessment and Research Centre, Moorgreen Hospital, Southampton, United Kingdom
    • ,
  • Gunhild Waldemar

      Affiliations

    • Memory Disorders Research Group, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
    • ,
  • Richard Zhang

      Affiliations

    • Pfizer Global Pharmaceuticals, Pfizer Inc, New York, NY, USA
    • ,
  • Rachel Schindler

      Affiliations

    • Pfizer Global Pharmaceuticals, Pfizer Inc, New York, NY, USA

Abstract 

Background

Numerous patient- and disease-related factors increase the risk of rapid cognitive decline in patients with Alzheimer's disease (AD). The ability of pharmacological treatment to attenuate this risk remains undefined.

Methods

Pooled data from 14 randomized clinical studies of donepezil in the treatment of AD (N = 3748) were analyzed to identify predictors of fast decline and determine the effect of donepezil on the risk of fast decline.

Results

Young age and more severe baseline cognitive, global, or behavioral status were identified as independent predictors of faster decline in placebo-treated patients. Multivariate models indicated that donepezil treatment was associated with a 39% to 63% reduction in the risk of faster decline.

Conclusions

These results correspond with previous findings, indicating relationships between age or baseline disease severity and rates of cognitive decline. Furthermore, they suggest that symptomatic therapy for AD could reduce the likelihood of faster decline in treated patients.

Keywords: Alzheimer's disease, Cognition, Clinical trials, Predictors, Donepezil, Placebo

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 Disclosures: The analyses described within this manuscript resulted from discussions undertaken through an expert working group initiated and funded by Eisai Inc. and Pfizer Inc. Drs. Schwam, Zhang, and Schindler are employees of Pfizer Inc. All other authors received honoraria from Pfizer Inc for participation in the expert working group. Dr. Cummings also reports having provided consultation to, and is on the speaker's bureau for, Eisai Inc. and Pfizer Inc.

PII: S1552-5260(10)00104-4

doi:10.1016/j.jalz.2010.04.003

Alzheimer's & Dementia: The Journal of the Alzheimer's Association
Volume 6, Issue 6 , Pages 431-439, November 2010

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