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Prediction of treatment response to rivastigmine in Alzheimer’s dementia

Abstract

Objectives: To predict the treatment response to rivastigmine in patients with Alzheimer’s dementia using neuropsychological and EEG data.

Methods: A neuropsychological examination and a quantitative EEG study were done in 20 patients with Alzheimer’s dementia before initiating treatment with rivastigmine. After one week of treatment a second EEG examination was done. Therapeutic efficacy was determined six months after treatment initiation. Treatment response was defined as improvement in short term memory after six months of rivastigmine treatment.

Results: For the group of patients as a whole, there was a significant improvement in short term memory and orientation during rivastigmine treatment. The mini-mental state score improved from 20.2 to 21.7 (NS). In the EEG, theta power decreased significantly after one week of treatment. Treatment responders had a greater decrease in theta power after one week of treatment and a better short term memory at baseline than non-responders. Decrease in theta power during rivastigmine treatment and baseline short term memory were good predictors of treatment response.

Conclusions: Generally available neuropsychological and EEG data may be useful for predicting response to rivastigmine in patients with Alzheimer’s disease.

  • Alzheimer’s disease
  • rivastigmine
  • GDS, global deterioration scale
  • IADL, instrumental activities of daily living scale
  • MMSE, mini-mental state examination
  • SIDAM, structured interview for the diagnosis of dementia of the Alzheimer type, multi-infarct dementia, and dementias of other aetiology
  • SISCO, SIDAM score

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