About 20% of Alzheimer's patients have severe dementia. As their health deteriorates they become less able to communicate, less mobile, and increasingly reliant on nursing care. Donepezil is used to treat mild-to-moderate Alzheimer's disease but its effectiveness in severe dementia has not been assessed until now.
In their trial Bengt Winblad (Karolinska Institutet, Huddinge, Sweden) and colleagues recruited Alzheimer's patients over 50 years of age from 50 nursing homes in Sweden. They assigned 95 patients to donepezil and 99 to a placebo for 6 months. The investigators found that those on donepezil had improved cognition and ability to carry out daily activities when compared with those on placebo. More patients on the active drug had side effects than those in the placebo group but these were usually transient and mild to moderate in severity.
Professor Winblad states: "Donepezil slows, and can reverse some aspects of deterioration of cognition and function in individuals with severe Alzheimer's who live in nursing homes."
See also accompanying Comment.
Contact: Bengt Winblad, Professor/Director Karolinska Institutet, Neurotec Dept, Novum, Floor 5, Division of Geriatrics, SE-141 57 Huddinge, Sweden. T) +46 8 585 854 74 / +46 70 632 67 71 (mobile)
The Lancet