Odor Identification Impairment and Change with Cholinesterase Inhibitor Treatment in Mild Cognitive Impairment
| Autor: | Yaakov Stern, Devangere P. Devanand, Edward D. Huey, Peter W. Schofield, Xinhua Liu, Richard E. Chunga, Howard Andrews, Jongwoo Choi, Gregory H. Pelton, Hannah R. Cohen |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty medicine.drug_class medicine.medical_treatment Neuropsychological Tests 03 medical and health sciences 0302 clinical medicine Internal medicine Anticholinergic medicine Humans Cognitive Dysfunction Donepezil Cognitive impairment Cholinesterase Aged Aged 80 and over biology business.industry General Neuroscience Mild cognitive impairment Cognition General Medicine Odor identification Alzheimer's disease Middle Aged Olfactory Perception Smell Psychiatry and Mental health Clinical Psychology Atropine 030104 developmental biology Nasal spray biology.protein Female Cholinesterase Inhibitors Geriatrics and Gerontology business human activities 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of Alzheimer's disease : JAD. 75(3) |
| ISSN: | 1875-8908 |
| Popis: | Background Anticholinergic challenge can induce odor identification impairment that indicates Alzheimer's disease (AD) pathology, and short-term change in odor identification impairment with cholinesterase inhibitor (CheI) treatment may predict longer term cognitive outcomes. Objective In patients with mild cognitive impairment (MCI) treated prospectively with donepezil, a CheI, for 52 weeks, to determine if 1) acute decline in odor identification ability with anticholinergic challenge can predict cognitive improvement, and 2) change in odor identification over 8 weeks can predict cognitive improvement. Methods MCI was diagnosed clinically without AD biomarkers. At baseline, the University of Pennsylvania Smell identification Test (UPSIT) was administered before and after an anticholinergic atropine nasal spray challenge. Donepezil was started at 5 mg daily, increased to 10 mg daily if tolerated, and this dose was maintained for 52 weeks. Main outcomes were ADAS-Cog total score and Selective Reminding Test (SRT) total immediate recall score measured at baseline, 26 and 52 weeks. Results In 100 study participants, mean age 70.14 (SD 9.35) years, atropine-induced decrease in UPSIT score at baseline was not associated with change in ADAS-Cog or SRT scores over 52 weeks. Change in UPSIT score from 0 to 8 weeks did not show a significant association with change in the ADAS-Cog or SRT measures over 52 weeks. Conclusion These negative findings in a relatively large sample of patients with MCI did not replicate results in much smaller samples. Change in odor identification with anticholinergic challenge, and over 8 weeks, may not be useful predictors of cognitive improvement with CheI in patients with MCI. |
| Databáze: | OpenAIRE |
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