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Donepezil (AriceptTM): The caregivers voice and clinical impression

Eric Comsti, MD

Outpatient Geriatric Department; Jersey Shore Medical Center, The Medical Center of Ocean County, Meridian Health System, and the Center of Aging at UMDNJ-SOM, Straford, New Jersey

Vered Shua-Haim, RN, BSN

Alzheimer's Research Corporation, ARC, Eatontown, New Jersey

Joel S. Ross, MD, FACP, AGSF

Outpatient Geriatric Department; Jersey Shore Medical Center, The Medical Center of Ocean County, Meridian Health System, and the Center of Aging at UMDNJ-SOM, Straford, New Jersey

The purpose of this study is to investigate the clinical and caregiver impression on Aricept^TM treatment. In a prospective study, 57 consecutive Alzheimer's disease patients were treated with Donepezil for 16 weeks, using a 5mg tablet, administered once daily at bedtime. Patients met the criteria of NINCDS-ADRDAI for probable Alzheimer's disease. There were no exclusion criteria for the study. After 16-weeks of treatment, the caregiver completed a questionnaire regarding the effectiveness of the drug. Subjective cognitive improvement, MMSE,² ADL,³ and IADL⁴ outcomes were all assessed before and after treatment.

Behavioral improvements included those of depression, agitation, violence, anxiety, and paranoid thoughts. Functional and overall family satisfaction was also evaluated Side effects and reason for discontinuation of the medication were also reported.

Out of the 57 patients in the study, 15 patients (26 percent) terminated participation due to side-effects. Total adverse event was reported in 24 (42 percent) of the patients. Cognitive improvement was reported in 27 (47 percent) of patients. Verbal skills and attention were the most commonly-reported cognitive improvement. Average MMSE declined by two points after 16 weeks of treatment. No behavioral improvement was reported Behavioral deterioration was reported in three (5 percent) of patients. Functional improvement was reported in 21 (37 percent) of patients. Favorable overall family satisfaction was reported in 27 (47 percent) patients.

Although the overall clinical impression from Aricept^TM (Donepezil) treatment (as measured by the MMSE, ADL, IADL and behavior) was unfavorable, there was a high family and caregiver satisfaction. This satisfaction was due mainly to functional improvement. The main cognitive improvement reported was in verbal skills and attention span.

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 12, No. 6, 272-279 (1997)
DOI: 10.1177/153331759701200605


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