Jared R Tinklenberg1, Helena C Kraemer2, Kristine Yaffe3, Ruth O'Hara2, John M Ringman4, John W Ashford2, Jerome A Yesavage2, Joy L Taylor2. 1. Sierra Pacific Mental Illness, Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA. Electronic address: jerytink@stanford.edu. 2. Sierra Pacific Mental Illness, Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA. 3. Department of Psychiatry, University of California, San Francisco, CA; Sierra Pacific Mental Illness, Research, Education and Clinical Center, Veterans Affairs San Francisco Health Care System, San Francisco, CA. 4. Mary S. Easton Center for Alzheimer's Disease Research, Department of Neurology, University of California Los Angeles, Los Angeles CA.
Abstract
OBJECTIVE: To compare the outcome of donepezil treatment in ethnically diverse Alzheimer disease (AD) patients with ethnically diverse AD patients who did not receive donepezil. METHODS: Patients meeting NINCDS-ADRA criteria for probable or possible AD from a consortium of California sites were systematically followed for at least 1 year in this prospective, observational study. Their treatment regimens, including prescription of donepezil, were determined by their individual physician according to his or her usual criteria. Patients self-identified their ethnicity. RESULTS: The 64 ethnically diverse AD patients who completed the study and received donepezil treatment had an average 1-year decline of 2.30 points (standard deviation: 3.9) on the 30-point Mini-Mental State Exam compared with a 1.70-point (standard deviation: 4.2) decline in the 74 ethnically diverse completers who received no donepezil or other anti-AD drugs during the study period. This difference was not statistically significant. The overall Cohen effect size of this treatment-associated difference was estimated at -0.15. After using propensity analyses and other techniques to assess factors that could bias prescribing decisions, the lack of benefits associated with donepezil treatment remained. The lack of donepezil benefits also remained when more traditional analyses were applied to these data. CONCLUSION: Ethnically diverse AD patients in this study apparently did not benefit from 1 year of donepezil treatment. These unpromising results are in contrast to modest benefits of donepezil treatment measured in a directly comparable California study involving white non-Latino AD patients. Published by Elsevier Inc.
OBJECTIVE: To compare the outcome of donepezil treatment in ethnically diverse Alzheimer disease (AD) patients with ethnically diverse ADpatients who did not receive donepezil. METHODS:Patients meeting NINCDS-ADRA criteria for probable or possible AD from a consortium of California sites were systematically followed for at least 1 year in this prospective, observational study. Their treatment regimens, including prescription of donepezil, were determined by their individual physician according to his or her usual criteria. Patients self-identified their ethnicity. RESULTS: The 64 ethnically diverse ADpatients who completed the study and received donepezil treatment had an average 1-year decline of 2.30 points (standard deviation: 3.9) on the 30-point Mini-Mental State Exam compared with a 1.70-point (standard deviation: 4.2) decline in the 74 ethnically diverse completers who received no donepezil or other anti-AD drugs during the study period. This difference was not statistically significant. The overall Cohen effect size of this treatment-associated difference was estimated at -0.15. After using propensity analyses and other techniques to assess factors that could bias prescribing decisions, the lack of benefits associated with donepezil treatment remained. The lack of donepezil benefits also remained when more traditional analyses were applied to these data. CONCLUSION: Ethnically diverse ADpatients in this study apparently did not benefit from 1 year of donepezil treatment. These unpromising results are in contrast to modest benefits of donepezil treatment measured in a directly comparable California study involving white non-Latino ADpatients. Published by Elsevier Inc.
Authors: C Courtney; D Farrell; R Gray; R Hills; L Lynch; E Sellwood; S Edwards; W Hardyman; J Raftery; P Crome; C Lendon; H Shaw; P Bentham Journal: Lancet Date: 2004-06-26 Impact factor: 79.321
Authors: Jerome A Yesavage; Jennifer Hoblyn; Javaid Sheikh; Jared R Tinklenberg; Art Noda; Ruth O'Hara; Catherine Fenn; Martin S Mumenthaler; Leah Friedman; Helena C Kraemer Journal: J Psychiatr Res Date: 2003 Nov-Dec Impact factor: 4.791
Authors: Lori A Newkirk; Janise M Kim; Jean M Thompson; Jared R Tinklenberg; Jerome A Yesavage; Joy L Taylor Journal: J Geriatr Psychiatry Neurol Date: 2004-06 Impact factor: 2.680
Authors: J Winchester; M B Dick; D Gillen; B Reed; B Miller; J Tinklenberg; D Mungas; H Chui; D Galasko; L Hewett; C W Cotman Journal: Arch Gerontol Geriatr Date: 2012-09-05 Impact factor: 3.250
Authors: Lori A Newkirk; Virginia L Dao; Joshua T Jordan; Loren I Alving; Helen D Davies; Linda Hewett; Sherry A Beaudreau; Logan D Schneider; Christine E Gould; Christina F Chick; Rayna B Hirst; Sophia Miryam Schüssler-Fiorenza Rose; Lauren A Anker; Jared R Tinklenberg; Ruth O'Hara Journal: J Alzheimers Dis Date: 2020 Impact factor: 4.472