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Long-term effects of rivastigmine treatment on neuropsychiatric and behavioral disturbances in nursing home residents with moderate to severe Alzheimer's disease: results of a 52-week open-label study.
Curr Med Res Opin. 2004 Oct; 20(10):1605-12.CM

Abstract

OBJECTIVES

To evaluate the safety and efficacy of long-term treatment with rivastigmine (3-12 mg/day) and its effects on neuropsychiatric and behavioral disturbances in nursing home patients with moderate to severe probable Alzheimer's disease (AD).

METHODS

A prospective, multicenter 26-week open-label extension to a 26-week open-label study (52 week results) of rivastigmine treatment in patients with Mini-Mental State Examination (MMSE) scores of 6-15 inclusive, residing in nursing homes at 13 centers in the US. Effects of treatment with rivastigmine for up to 52 weeks on neuropsychiatric and behavioral symptoms were examined using the Neuropsychiatric Inventory-Nursing Home (NPI-NH) scale. Cognitive function was assessed by the MMSE, and the Naming Objects and Fingers Test (NOFT) subset of the Alzheimer's Disease Assessment Scale -- Cognitive subscale (ADAS-Cog). Global functioning was assessed using the simplified Clinician's Interview-Based Impression of Change Plus Caregiver Input (CIBIC-Plus).

RESULTS

Rivastigmine (3-12 mg/day) significantly improved neuropsychiatric and behavioral symptoms compared to baseline (in patients with specific behavioral disturbances at baseline) in observed cases (OC) and last observation carried forward (LOCF) analyses. Over 52 weeks, treatment with rivastigmine significantly improved 10 of 12 individual NPI-NH domains from baseline in LOCF patients with symptoms present at baseline. Cognitive function was stable, indicated by the lack of decline in MMSE and the NOFT. Global function was stabilized or improved in greater than half of the patients as indicated by the simplified CIBIC-Plus scores.

CONCLUSION

Rivastigmine showed potential benefit in the long-term treatment of behavioral symptoms as well as cognitive and global functioning in nursing home residents with moderate to severe AD with concurrent behavioral symptoms present at baseline. Although these results suggest that treatment with rivastigmine may have beneficial behavioral effects and cognitive benefits on patients with moderate to severe AD, they are subject to the limitations of an open-label study.

Authors+Show Affiliations

Aupperle PM
Division of Geriatric Psychiatry, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway, NJ, USA. aupperpm@umdnj.edu
Koumaras B
No affiliation info available
Chen M
No affiliation info available
Rabinowicz A
No affiliation info available
Mirski D
No affiliation info available

MeSH

Administration, OralAgedAged, 80 and overAlzheimer DiseaseCognition DisordersDose-Response Relationship, DrugFemaleHumansMaleMental Status ScheduleNeuroprotective AgentsNeuropsychological TestsNursing HomesPhenylcarbamatesProspective StudiesRivastigmineSeverity of Illness IndexTreatment Outcome

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15462693

Citation

Aupperle, Peter M., et al. "Long-term Effects of Rivastigmine Treatment On Neuropsychiatric and Behavioral Disturbances in Nursing Home Residents With Moderate to Severe Alzheimer's Disease: Results of a 52-week Open-label Study." Current Medical Research and Opinion, vol. 20, no. 10, 2004, pp. 1605-12.
Aupperle PM, Koumaras B, Chen M, et al. Long-term effects of rivastigmine treatment on neuropsychiatric and behavioral disturbances in nursing home residents with moderate to severe Alzheimer's disease: results of a 52-week open-label study. Curr Med Res Opin. 2004;20(10):1605-12.
Aupperle, P. M., Koumaras, B., Chen, M., Rabinowicz, A., & Mirski, D. (2004). Long-term effects of rivastigmine treatment on neuropsychiatric and behavioral disturbances in nursing home residents with moderate to severe Alzheimer's disease: results of a 52-week open-label study. Current Medical Research and Opinion, 20(10), 1605-12.
Aupperle PM, et al. Long-term Effects of Rivastigmine Treatment On Neuropsychiatric and Behavioral Disturbances in Nursing Home Residents With Moderate to Severe Alzheimer's Disease: Results of a 52-week Open-label Study. Curr Med Res Opin. 2004;20(10):1605-12. PubMed PMID: 15462693.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term effects of rivastigmine treatment on neuropsychiatric and behavioral disturbances in nursing home residents with moderate to severe Alzheimer's disease: results of a 52-week open-label study. AU - Aupperle,Peter M, AU - Koumaras,Barbara, AU - Chen,Michael, AU - Rabinowicz,Adrian, AU - Mirski,Dario, PY - 2004/10/7/pubmed PY - 2005/2/8/medline PY - 2004/10/7/entrez SP - 1605 EP - 12 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 20 IS - 10 N2 - OBJECTIVES: To evaluate the safety and efficacy of long-term treatment with rivastigmine (3-12 mg/day) and its effects on neuropsychiatric and behavioral disturbances in nursing home patients with moderate to severe probable Alzheimer's disease (AD). METHODS: A prospective, multicenter 26-week open-label extension to a 26-week open-label study (52 week results) of rivastigmine treatment in patients with Mini-Mental State Examination (MMSE) scores of 6-15 inclusive, residing in nursing homes at 13 centers in the US. Effects of treatment with rivastigmine for up to 52 weeks on neuropsychiatric and behavioral symptoms were examined using the Neuropsychiatric Inventory-Nursing Home (NPI-NH) scale. Cognitive function was assessed by the MMSE, and the Naming Objects and Fingers Test (NOFT) subset of the Alzheimer's Disease Assessment Scale -- Cognitive subscale (ADAS-Cog). Global functioning was assessed using the simplified Clinician's Interview-Based Impression of Change Plus Caregiver Input (CIBIC-Plus). RESULTS: Rivastigmine (3-12 mg/day) significantly improved neuropsychiatric and behavioral symptoms compared to baseline (in patients with specific behavioral disturbances at baseline) in observed cases (OC) and last observation carried forward (LOCF) analyses. Over 52 weeks, treatment with rivastigmine significantly improved 10 of 12 individual NPI-NH domains from baseline in LOCF patients with symptoms present at baseline. Cognitive function was stable, indicated by the lack of decline in MMSE and the NOFT. Global function was stabilized or improved in greater than half of the patients as indicated by the simplified CIBIC-Plus scores. CONCLUSION: Rivastigmine showed potential benefit in the long-term treatment of behavioral symptoms as well as cognitive and global functioning in nursing home residents with moderate to severe AD with concurrent behavioral symptoms present at baseline. Although these results suggest that treatment with rivastigmine may have beneficial behavioral effects and cognitive benefits on patients with moderate to severe AD, they are subject to the limitations of an open-label study. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/15462693/Long_term_effects_of_rivastigmine_treatment_on_neuropsychiatric_and_behavioral_disturbances_in_nursing_home_residents_with_moderate_to_severe_Alzheimer's_disease:_results_of_a_52_week_open_label_study_ DB - PRIME DP - Unbound Medicine ER -