Does donepezil improve the well-being of patients with dementia?

From: The Cochrane Collaboration

Journal rating:
rating: 98%
Study Quality:
rating: 100%
%

Overall Reliability

Article Quality:
rating: 65%
Partcipants
rating: 50%

Participants/situation

  • 24 trials are included, involving 5,796 participants

Study

  • The paper is a systematic review / meta analysis of all relevant trials.
  • This means that the data from all similar trials has been grouped to form an overall outcome.

Results

  • For cognition there is a statistically significant improvement for both 5 and 10 mg/day of donepezil at 24 weeks compared with placebo, and for 10 mg/day donepezil compared with placebo at 24 weeks and 52 weeks.
  • Benefits of treatment were also seen for activities of daily living and behaviour, but not on the quality of life score.
  • Many adverse events were recorded, with more incidents of nausea, vomiting, diarrhoea, muscle cramps, dizziness, fatigue and anorexia (significant risk associated with treatment) in the 10 mg/day group, compared with placebo.
  • There were more incidents of anorexia, diarrhoea, and muscle cramps in the 5 mg/day group compared with placebo, but not of dizziness, fatigue, nausea or vomiting.

Answer

  • Yes (with confidence)

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Editors Notes

  • Mild dementia - impairment of attention and memory; forgetting of recent information; occasional confusion or disorientation; some help needed with everyday activities
  • Moderate dementia - amnesia for recent events; some disorientation for time and place; impairment of reasoning and ability to understand events, resulting in dependency on others in personal care and routine daily tasks
  • Severe dementia - incoherent speech; disorientation for time, place and person; failure to recognise close relatives, incontinence of urine and faeces; complete dependence on others for basic personal care.

Keywords