Clinical Interventions in Aging
Open access peer-reviewed scientific and medical journals.
Dove Medical Press is now a member of the Open Access Initiative
An Author's Guide
A guide to help authors get their paper published.
Support Open Access and Dove Press
Promotional Article Monitoring - further details
Favored Author Program
Real benefits for authors, including fast-track processing of papers.
Impact of cholinesterase inhibitors on behavioral and psychological symptoms of Alzheimer’s disease: A meta-analysis
(9833) Total Article Views
Authors: Noll Campbell, Amir Ayub, Malaz A Boustani, Chris Fox, Martin Farlow, et al
Published Date October 2008
Volume 2008:3(4) Pages 719 - 728
Noll Campbell1, Amir Ayub2, Malaz A Boustani2, Chris Fox3, Martin Farlow4, Ian Maidment3, Robert Howard5
1Wishard Health Services, Indianapolis, Indiana; 2Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, Indiana; 3University of Kent, Kent, United Kingdom; 4Indiana University School of Medicine, Indianapolis, Indiana; 5King’s College, London, United Kingdom
Objective: To determine the efficacy of cholinesterase inhibitors (ChEIs) in improving the behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer’s disease (AD).
Data sources: We searched MEDLINE, Cochrane Registry, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from 1966 to 2007. We limited our search to English Language, full text, published articles and human studies.
Data extraction: We included randomized, double-blind, placebo-controlled trials evaluating the efficacy of donepezil, rivastigmine, or galantamine in managing BPSD displayed by AD patients. Using the United States Preventive Services Task Force (USPSTF) guidelines, we critically appraised all studies and included only those with an attrition rate of less than 40%, concealed measurement of the outcomes, and intention to treat analysis of the collected data. All data were imputed into pre-defined evidence based tables and were pooled using the Review Manager 4.2.1 software for data synthesis.
Results: We found 12 studies that met our inclusion criteria but only nine of them provided sufficient data for the meta-analysis. Among patients with mild to severe AD and in comparison to placebo, ChEIs as a class had a beneficial effects on reducing BPSD with a standard mean difference (SMD) of −0.10 (95% confidence interval [CI]; −0.18, −0.01) and a weighted mean difference (WMD) of −1.38 neuropsychiatry inventory point (95% CI; −2.30, −0.46). In studies with mild AD patients, the WMD was −1.92 (95% CI; −3.18, −0.66); and in studies with severe AD patients, the WMD was −0.06 (95% CI; −2.12, +0.57).
Conclusion: Cholinesterase inhibitors lead to a statistical significant reduction in BPSD among patients with AD, yet the clinical relevance of this effect remains unclear.
Keywords: Alzheimer’s disease, dementia, cholinesterase inhibitors, behavioral and psychological symptoms
Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter
Other articles by Dr Malaz Malaz Boustani
Readers of this article also read:
- New eBook
Have a look at Dr Richard Walker's must read eBook on Amazon Kindle Why we age: Insight into the cause of growing old
- American Acne and Rosacea Society
The American Acne and Rosacea Society (AARS) is a 501(c)(6) non-profit organization dedicated to elevating the understanding and treatment of acne and rosacea.
- Have an opinion about one of our articles?
We encourage you to write a letter to the editor.
- MLA'14 -
May 16–21, 2014
- CINP World Congress
22 - 26 June, 2014
- 27th ECNP Congress
18 - 21 October, 2014
- Radio electric asymmetric brain stimulation in the treatment of behavioral and psychiatric symptoms in Alzheimer disease
- Eggshell membrane: A possible new natural therapeutic for joint and connective tissue disorders. Results from two open-label human clinical studies
- Comparison of two treatments for coxarthrosis: local hyperthermia versus radio electric asymmetrical brain stimulation
- The cognitive impact of anticholinergics: A clinical review