Different clinical effect of four antidementia drugs for Alzheimer's disease patients depending on white matter severity

Yusuke Fukui, Nozomi Hishikawa, Jin Ichinose, Kota Sato, Yumiko Nakano, Ryuta Morihara, Yasuyuki Ohta, Toru Yamashita, Koji Abe

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aim: To examine the clinical effect of four antidementia drugs (donepezil, galantamine, rivastigmine and memantine) in Alzheimer's disease patients who were divided into subgroups based on their periventricular hyperintensity (PVH) severity. Methods: A total of 551 Alzheimer's disease patients (201 men and 350 women) were divided into four subgroups based on their PVH severity (0-III). They received monotherapy for 12 months. We compared the clinical effects at the baseline, and at 3, 6 and 12 months after initiation. Results: The baseline age became higher with PVH grades, and the Mini-Mental State Examination and Hasegawa Dementia Scale-Revised showed a decrease that was dependent on white matter severity. Although the PVH 0 subgroup showed stable cognitive, affective and ADL functions until 12 months in all four drug groups, the PVH I subgroup showed an improved Apathy Scale from the baseline in response to memantine at 3 and 9 months (P < 0.05), and galantamine at 9 months (P < 0.01). In the PVH II subgroup, the Mini-Mental State Examination showed a significant improvement from the baseline in response to galantamine (P < 0.05) at 9 months and Hasegawa Dementia Scale-Revised (P < 0.05) at 3 months. In the PVH III subgroup, cognitive and affective functions were preserved in all four drug groups until 12 months, but activities of daily living deteriorated in the riverstigmine group at 6 and 12 months (P < 0.05). Conclusions: The present study shows that these four drugs showed sensitivity dependent on white matter severity that clinically affected cognitive, affective and activities of daily living functions.

Original languageEnglish
JournalGeriatrics and Gerontology International
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Galantamine
dementia
Alzheimer Disease
Activities of Daily Living
Memantine
drug
Rivastigmine
Pharmaceutical Preparations
Dementia
Apathy
apathy
examination
Group
Cognition
White Matter

Keywords

  • Alzheimer's disease
  • Antidementia drug
  • Magnetic resonance imaging
  • Periventricular hyperintensity
  • White matter lesions

ASJC Scopus subject areas

  • Health(social science)
  • Gerontology
  • Geriatrics and Gerontology

Cite this

@article{6c65573406a347879259d28176bf5cfe,
title = "Different clinical effect of four antidementia drugs for Alzheimer's disease patients depending on white matter severity",
abstract = "Aim: To examine the clinical effect of four antidementia drugs (donepezil, galantamine, rivastigmine and memantine) in Alzheimer's disease patients who were divided into subgroups based on their periventricular hyperintensity (PVH) severity. Methods: A total of 551 Alzheimer's disease patients (201 men and 350 women) were divided into four subgroups based on their PVH severity (0-III). They received monotherapy for 12 months. We compared the clinical effects at the baseline, and at 3, 6 and 12 months after initiation. Results: The baseline age became higher with PVH grades, and the Mini-Mental State Examination and Hasegawa Dementia Scale-Revised showed a decrease that was dependent on white matter severity. Although the PVH 0 subgroup showed stable cognitive, affective and ADL functions until 12 months in all four drug groups, the PVH I subgroup showed an improved Apathy Scale from the baseline in response to memantine at 3 and 9 months (P < 0.05), and galantamine at 9 months (P < 0.01). In the PVH II subgroup, the Mini-Mental State Examination showed a significant improvement from the baseline in response to galantamine (P < 0.05) at 9 months and Hasegawa Dementia Scale-Revised (P < 0.05) at 3 months. In the PVH III subgroup, cognitive and affective functions were preserved in all four drug groups until 12 months, but activities of daily living deteriorated in the riverstigmine group at 6 and 12 months (P < 0.05). Conclusions: The present study shows that these four drugs showed sensitivity dependent on white matter severity that clinically affected cognitive, affective and activities of daily living functions.",
keywords = "Alzheimer's disease, Antidementia drug, Magnetic resonance imaging, Periventricular hyperintensity, White matter lesions",
author = "Yusuke Fukui and Nozomi Hishikawa and Jin Ichinose and Kota Sato and Yumiko Nakano and Ryuta Morihara and Yasuyuki Ohta and Toru Yamashita and Koji Abe",
year = "2017",
doi = "10.1111/ggi.13007",
language = "English",
journal = "Geriatrics and Gerontology International",
issn = "1447-0594",
publisher = "Japan Geriatrics Society",

}

TY - JOUR

T1 - Different clinical effect of four antidementia drugs for Alzheimer's disease patients depending on white matter severity

AU - Fukui, Yusuke

AU - Hishikawa, Nozomi

AU - Ichinose, Jin

AU - Sato, Kota

AU - Nakano, Yumiko

AU - Morihara, Ryuta

AU - Ohta, Yasuyuki

AU - Yamashita, Toru

AU - Abe, Koji

PY - 2017

Y1 - 2017

N2 - Aim: To examine the clinical effect of four antidementia drugs (donepezil, galantamine, rivastigmine and memantine) in Alzheimer's disease patients who were divided into subgroups based on their periventricular hyperintensity (PVH) severity. Methods: A total of 551 Alzheimer's disease patients (201 men and 350 women) were divided into four subgroups based on their PVH severity (0-III). They received monotherapy for 12 months. We compared the clinical effects at the baseline, and at 3, 6 and 12 months after initiation. Results: The baseline age became higher with PVH grades, and the Mini-Mental State Examination and Hasegawa Dementia Scale-Revised showed a decrease that was dependent on white matter severity. Although the PVH 0 subgroup showed stable cognitive, affective and ADL functions until 12 months in all four drug groups, the PVH I subgroup showed an improved Apathy Scale from the baseline in response to memantine at 3 and 9 months (P < 0.05), and galantamine at 9 months (P < 0.01). In the PVH II subgroup, the Mini-Mental State Examination showed a significant improvement from the baseline in response to galantamine (P < 0.05) at 9 months and Hasegawa Dementia Scale-Revised (P < 0.05) at 3 months. In the PVH III subgroup, cognitive and affective functions were preserved in all four drug groups until 12 months, but activities of daily living deteriorated in the riverstigmine group at 6 and 12 months (P < 0.05). Conclusions: The present study shows that these four drugs showed sensitivity dependent on white matter severity that clinically affected cognitive, affective and activities of daily living functions.

AB - Aim: To examine the clinical effect of four antidementia drugs (donepezil, galantamine, rivastigmine and memantine) in Alzheimer's disease patients who were divided into subgroups based on their periventricular hyperintensity (PVH) severity. Methods: A total of 551 Alzheimer's disease patients (201 men and 350 women) were divided into four subgroups based on their PVH severity (0-III). They received monotherapy for 12 months. We compared the clinical effects at the baseline, and at 3, 6 and 12 months after initiation. Results: The baseline age became higher with PVH grades, and the Mini-Mental State Examination and Hasegawa Dementia Scale-Revised showed a decrease that was dependent on white matter severity. Although the PVH 0 subgroup showed stable cognitive, affective and ADL functions until 12 months in all four drug groups, the PVH I subgroup showed an improved Apathy Scale from the baseline in response to memantine at 3 and 9 months (P < 0.05), and galantamine at 9 months (P < 0.01). In the PVH II subgroup, the Mini-Mental State Examination showed a significant improvement from the baseline in response to galantamine (P < 0.05) at 9 months and Hasegawa Dementia Scale-Revised (P < 0.05) at 3 months. In the PVH III subgroup, cognitive and affective functions were preserved in all four drug groups until 12 months, but activities of daily living deteriorated in the riverstigmine group at 6 and 12 months (P < 0.05). Conclusions: The present study shows that these four drugs showed sensitivity dependent on white matter severity that clinically affected cognitive, affective and activities of daily living functions.

KW - Alzheimer's disease

KW - Antidementia drug

KW - Magnetic resonance imaging

KW - Periventricular hyperintensity

KW - White matter lesions

UR - http://www.scopus.com/inward/record.url?scp=85014773667&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014773667&partnerID=8YFLogxK

U2 - 10.1111/ggi.13007

DO - 10.1111/ggi.13007

M3 - Article

C2 - 28276131

AN - SCOPUS:85014773667

JO - Geriatrics and Gerontology International

JF - Geriatrics and Gerontology International

SN - 1447-0594

ER -