Does donepezil improve the well-being of patients with dementia?
From: The Cochrane Collaboration
- Birks, J., Harvey, R.J., 1996. Donepezil for dementia due to Alzheimer’s disease, in: Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd.
- 24 trials are included, involving 5,796 participants
- 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.
- 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.
- Yes (with confidence)
- 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.