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Smell identification test as a treatment response marker in patients with Alzheimer disease receiving donepezil

Authors

Velayudhan, Latha, Lovestone, Simon

Journal

Journal Of Clinical Psychopharmacology, Volume: 29, No.: 4, Pages.: 387-390

Year of Publication

2009

Abstract

Background: Olfactory dysfunction, impaired odor identification in particular, is known to occur in Alzheimer disease (AD). The entorhinal cortex and the olfactory bulb, critical areas for olfactory function, are rich in acetylcholine, the neurotransmitter implicated in AD pathology and treatment. In view of the common anatomical substrate, we aimed to determine whether performance on an olfaction test can be used as a clinical marker for monitoring the efficacy of donepezil in elderly people with AD.; Methods: Twenty-five participants with mild to moderate AD, planned for donepezil treatment, were recruited from mental health services for older adults in this open-labeled study. Assessments before commencing donepezil included Mini-Mental State Examination, Neuropsychiatric Inventory, Bristol Activities of Daily Living, and the University of Pennsylvania Smell Identification Test. After 3 months of treatment, the primary outcome measure, the Clinician Interview Based Impression of Change plus caregiver input (CIBIC-plus), was completed, and the baseline assessments were repeated.; Results: Eighteen patients continued to receive donepezil at follow-up. The CIBIC-plus outcome correlated with changes in University of Pennsylvania Smell Identification Test and Bristol Activities of Daily Living scores from the baseline (r = 0.7, P < 0.01). In addition, it was the change in smell identification function after treatment that best predicted CIBIC-plus outcome (P < 0.05) on ordinal regression analysis.; Conclusions: Smell identification function could be useful as a clinical measure to assess treatment response with donepezil in AD. This is a nonblind uncontrolled study, and the outcome indicates the need for a controlled study.;

Bibtex Citation

@article{Velayudhan_2009, doi = {10.1097/jcp.0b013e3181aba5a5}, url = {http://dx.doi.org/10.1097/JCP.0b013e3181aba5a5}, year = 2009, month = {aug}, publisher = {Ovid Technologies (Wolters Kluwer Health)}, volume = {29}, number = {4}, pages = {387--390}, author = {Latha Velayudhan and Simon Lovestone}, title = {Smell Identification Test as a Treatment Response Marker in Patients With Alzheimer Disease Receiving Donepezil}, journal = {Journal of Clinical Psychopharmacology} }

Keywords

aged, aged, 80 and over, alzheimer disease, cholinesterase inhibitors, complications, donepezil, drug effects, drug monitoring, drug therapy, etiology, female, humans, indans, male, methods, odors, olfaction disorders, physiopathology, piperidines, predictive value of tests, severity of illness index, smell, therapeutic use, treatment outcome

Countries of Study

UK

Types of Dementia

Alzheimer’s Disease

Types of Study

Before and After Study

Type of Outcomes

Cognition

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

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