Department of Neurology, Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA.
Alzheimers Dement. 2010 Nov;6(6):431-9. doi: 10.1016/j.jalz.2010.04.003.
Numerous patient- and disease-related factors increase the risk of rapid cognitive decline in patients with Alzheimer's disease (AD). The ability of pharmacological treatment to attenuate this risk remains undefined.
Pooled data from 14 randomized clinical studies of donepezil in the treatment of AD (N = 3748) were analyzed to identify predictors of fast decline and determine the effect of donepezil on the risk of fast decline.
Young age and more severe baseline cognitive, global, or behavioral status were identified as independent predictors of faster decline in placebo-treated patients. Multivariate models indicated that donepezil treatment was associated with a 39% to 63% reduction in the risk of faster decline.
These results correspond with previous findings, indicating relationships between age or baseline disease severity and rates of cognitive decline. Furthermore, they suggest that symptomatic therapy for AD could reduce the likelihood of faster decline in treated patients.
许多与患者和疾病相关的因素会增加阿尔茨海默病（AD）患者认知能力快速下降的风险。药物治疗减轻这种风险的能力尚未确定。
对多奈哌齐治疗 AD 的 14 项随机临床试验的汇总数据（N=3748）进行分析，以确定快速下降的预测因素，并确定多奈哌齐对快速下降风险的影响。
年龄较小和基线认知、整体或行为状态更严重被确定为安慰剂治疗患者更快下降的独立预测因素。多变量模型表明，多奈哌齐治疗与更快下降风险降低 39%至 63%相关。
这些结果与之前的研究结果一致，表明年龄或基线疾病严重程度与认知下降速度之间存在关系。此外，它们表明 AD 的症状治疗可以降低治疗患者更快下降的可能性。
