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Verbal repetition in patients with Alzheimer's disease who receive donepezil
Author(s) -
Asp Elissa,
Cloutier France,
Fay Sherri,
Cook Cheryl,
Robertson Mary Lou,
Fisk John,
Dei DingWai,
Rockwood Kenneth
Publication year - 2006
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.1486
Subject(s) - donepezil , repetition (rhetorical device) , psychology , cognition , alzheimer's disease , dementia , disease , goal attainment scaling , set (abstract data type) , audiology , developmental psychology , clinical psychology , medicine , psychiatry , linguistics , philosophy , computer science , programming language , intervention (counseling)
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. Copyright © 2006 John Wiley & Sons, Ltd.