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Long-term outcome and prediction models of activities of daily living in Alzheimer disease with cholinesterase inhibitor treatment


Wattmo, Carina, Wallin, Åsa K., Londos, Elisabet, Minthon, Lennart


Alzheimer Disease And Associated Disorders, Volume: 25, No.: 1, Pages.: 63-72

Year of Publication



In untreated patients with Alzheimer disease (AD) the functional ability is gradually lost. What happens to the patients after continuous long-term cholinesterase inhibitor (ChEI) treatment is less investigated. The objective of this study was to describe the longitudinal functional outcome and analyze factors affecting the outcome in ChEI-treated patients. In an open, 3-year, nonrandomized, prospective, multicenter study in a routine clinical setting, 790 patients were treated with either donepezil, rivastigmine, or galantamine. At baseline and every 6 months, they were assessed with several rating scales including Instrumental Activities of Daily Living (IADL), Physical Self-Maintenance Scale (PSMS), and Mini-Mental State Examination (MMSE). A faster functional decline was associated with lower cognitive ability at baseline, older age, and the interaction of higher education and longer time in the study. The patients residing with a spouse or relative showed slower deterioration in IADL score. A higher mean dose of ChEI, regardless of drug agent, was also related to slower instrumental ADL decline. Prediction models for longitudinal functional outcome were provided. AD severity at baseline is a key factor in obtaining reliable clinical prognoses of the long-term ADL ability. The dosage of ChEI treatment could possibly lead to a different functional outcome.; Copyright © 2011 by Lippincott Williams & Wilkins

Bibtex Citation

@article{Wattmo_2011, doi = {10.1097/wad.0b013e3181f5dd97}, url = {}, year = 2011, publisher = {Ovid Technologies (Wolters Kluwer Health)}, volume = {25}, number = {1}, pages = {63--72}, author = {Carina Wattmo and {AA}sa K. Wallin and Elisabet Londos and Lennart Minthon}, title = {Long-term Outcome and Prediction Models of Activities of Daily Living in Alzheimer Disease With Cholinesterase Inhibitor Treatment}, journal = {Alzheimer Disease {&} Associated Disorders} }


activities of daily living, administration & dosage, aged, alzheimer disease, cholinesterase inhibitors, complications, disease progression, donepezil, drug therapy, female, galantamine, humans, indans, longitudinal studies, male, neuropsychological tests, phenylcarbamates, piperidines, therapeutic use, treatment outcome

Countries of Study


Types of Dementia

Alzheimer’s Disease

Types of Study

Non randomised controlled trial

Type of Outcomes

ADLs/IADLs, Cognition


Hospital Outpatient Care

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime