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Verbal repetition in patients with Alzheimer's disease who receive donepezil.
Int J Geriatr Psychiatry. 2006 May; 21(5):426-31.IJ

Abstract

BACKGROUND

Current outcome measures for Alzheimer's disease (AD) drugs have been criticized as insufficiently patient-centred. One commonly unmeasured goal of patients and caregivers is verbal repetition.

OBJECTIVES

We examined how often reducing repetition (of questions, statements or stories) was set as treatment goal, whether and when it responded, and how change in repetition correlated with change in other domains.

METHODS

This is a secondary analysis of the open-label Atlantic Canada Alzheimer's Disease Investigation of Expectations study of donepezil for mild-moderate AD in 100 community-dwelling people. Goal Attainment Scaling, an individualized account of the goals of treatment, was the primary outcome measure.

RESULTS

Reducing repetition was a treatment goal in 46%, who were not systematically different from others. Of 18 patients in whom repetition improved for 9 months, 83% (15) showed a response at 3 months. Early (3-month) response correlated best with the overall level of goal attainment (r = 0.74) and changes in leisure activities (r = 0.69) and social interactions (r = 0.68) compared with changes in cognition (r = 0.44) or behaviour (r = 0.11). Correlations with the ADAS-Cog and MMSE change scores remained only modest (at 12 months = -0.25 and 0.19, respectively). Correlations with the CIBIC-Plus were higher (-0.47 at 3 months and -0.43 at 12 months).

CONCLUSION

Diminution of repetition is common, and appears to mark response to cholinesterase inhibition in some patients. Responders generally also show improved cognition and function, perhaps as an aspect of improved executive function.

Authors+Show Affiliations

Geriatric Medicine Research Unit, Dalhousie University, Halifax, NS, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16676290

Citation

Asp, Elissa, et al. "Verbal Repetition in Patients With Alzheimer's Disease Who Receive Donepezil." International Journal of Geriatric Psychiatry, vol. 21, no. 5, 2006, pp. 426-31.
Asp E, Cloutier F, Fay S, et al. Verbal repetition in patients with Alzheimer's disease who receive donepezil. Int J Geriatr Psychiatry. 2006;21(5):426-31.
Asp, E., Cloutier, F., Fay, S., Cook, C., Robertson, M. L., Fisk, J., Dei, D. W., & Rockwood, K. (2006). Verbal repetition in patients with Alzheimer's disease who receive donepezil. International Journal of Geriatric Psychiatry, 21(5), 426-31.
Asp E, et al. Verbal Repetition in Patients With Alzheimer's Disease Who Receive Donepezil. Int J Geriatr Psychiatry. 2006;21(5):426-31. PubMed PMID: 16676290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Verbal repetition in patients with Alzheimer's disease who receive donepezil. AU - Asp,Elissa, AU - Cloutier,France, AU - Fay,Sherri, AU - Cook,Cheryl, AU - Robertson,Mary Lou, AU - Fisk,John, AU - Dei,Ding-Wai, AU - Rockwood,Kenneth, PY - 2006/5/6/pubmed PY - 2007/1/5/medline PY - 2006/5/6/entrez SP - 426 EP - 31 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 21 IS - 5 N2 - BACKGROUND: Current outcome measures for Alzheimer's disease (AD) drugs have been criticized as insufficiently patient-centred. One commonly unmeasured goal of patients and caregivers is verbal repetition. OBJECTIVES: We examined how often reducing repetition (of questions, statements or stories) was set as treatment goal, whether and when it responded, and how change in repetition correlated with change in other domains. METHODS: This is a secondary analysis of the open-label Atlantic Canada Alzheimer's Disease Investigation of Expectations study of donepezil for mild-moderate AD in 100 community-dwelling people. Goal Attainment Scaling, an individualized account of the goals of treatment, was the primary outcome measure. RESULTS: Reducing repetition was a treatment goal in 46%, who were not systematically different from others. Of 18 patients in whom repetition improved for 9 months, 83% (15) showed a response at 3 months. Early (3-month) response correlated best with the overall level of goal attainment (r = 0.74) and changes in leisure activities (r = 0.69) and social interactions (r = 0.68) compared with changes in cognition (r = 0.44) or behaviour (r = 0.11). Correlations with the ADAS-Cog and MMSE change scores remained only modest (at 12 months = -0.25 and 0.19, respectively). Correlations with the CIBIC-Plus were higher (-0.47 at 3 months and -0.43 at 12 months). CONCLUSION: Diminution of repetition is common, and appears to mark response to cholinesterase inhibition in some patients. Responders generally also show improved cognition and function, perhaps as an aspect of improved executive function. SN - 0885-6230 UR - https://www.unboundmedicine.com/medline/citation/16676290/Verbal_repetition_in_patients_with_Alzheimer's_disease_who_receive_donepezil_ L2 - https://doi.org/10.1002/gps.1486 DB - PRIME DP - Unbound Medicine ER -