The Effects of a Cholinesterase Inhibitor Are Prominent in Patients With Fluctuating Cognition: A Part 3 Study of the Main Mechanism of Cholinesterase Inhibitors in Dementia.

Fluctuating cognition is evidenced in different forms of dementia and is accompanied by electroencephalographic (EEG) abnormalities. The authors hypothesize that cholinesterase inhibitors are effective mostly in patients with fluctuating cognition. Twenty-three patients affected by mild dementia with similar scores on Mini-Mental State Examination (MMSE), Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog), and Unified Parkinson's Disease Rating Scale evaluation were classified in a group with fluctuating cognition and a group of nonfluctuators (n = 12). All patients were assigned to the branches of a double-blind crossover study of donepezil (DPZ), a 5 to 10-mg dose, versus vitamin E, a 2000 IU dose, for 30 days. Short-term DPZ administration induced a significant increase in MMSE scores, reduction of ADAS-cog and of NPI scores, increase of EEG a activity and reductions of P3 latency and jitter, dominant frequency variability and CRTV in the fluctuating cognition group, and significant increases of MMSE scores and a decrease of P3 jitter and dominant frequency variability in the nonfluctuating group. Significant effects of the 6-month observation were observed only in fluctuating cognition patients. (PsycInfo Database Record (c) 2023 APA, all rights reserved)