Rivastigmine in the Treatment of Dementia Associated with Parkinson's Disease: Effects on Activities of Daily Living

Aims: To investigate the effects of rivastigmine capsule 3-12 mg/day over 24 weeks on activities of daily living (ADLs) in patients with dementia associated with Parkinson's disease (PDD). Methods: Post hoc analysis of a prospective, multicenter, randomized, double-blind, placebo-controlled trial in patients with PDD (>= 50 years) randomized to rivastigmine 3-12 mg/day (capsules bid) or placebo over 24 weeks. This analysis was carried out with three subscales derived from a factor analysis of the 23 items in the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) scale. These subscales were basic ADLs (10 items), high-level function ADLs (eight items) and autonomy ADLs (five items). Results: 541 patients were randomized (362 to rivastigmine, 179 to placebo) and 410 (75.8%) completed the study. Rivastigmine was associated with significantly better outcomes in basic ADLs (-0.5 +/- 6.19 vs. -1.7 +/- 5.46; p = 0.025; effect size 22.1%) and high-level function ADLs (0.1 +/- 4.95 vs. -1.0 +/- 4.49; p = 0.017; effect size 22.9%) compared with placebo, at week 24. Conclusion: In patients with PDD, treatment with rivastigmine may show beneficial effects on overall ADLs, as well as modest, statistically significant improvements in basic ADLs and high-level function ADLs. Copyright (C) 2010 S. Karger AG, Basel