Abstract
Background/objective: There are few reports on the effects of
anti-Alzheimer’s disease (AD) drugs on older AD patients, and possible differences based
on gender in a real world setting.
Methods: “Okayama Late Dementia Study (OLDS)” is a retrospective clinical
cohort study focusing on older AD patients (n = 373; age≥75 years)
treated with monotherapy donepezil (n = 55), galantamine
(n = 222), rivastigmine (n = 63), or memantine
(n = 33). The patients were evaluated as an entire group and separated
by gender, using seven batteries for dementia assessment at baseline and at 3, 6, and 12
months of drug therapy.
Results: All four drugs preserved cognitive and affective functions until 12
months, except for Frontal Assessment Battery (FAB) with memantine ( *
p < 0.05 versus baseline). Donepezil monotherapy significantly
improved Hasegawa Dementia Rating Scale-Revised (HDS-R) at 3 months ( *
p < 0.05), and memantine (3 and 6 months, *
p < 0.05) and rivastigmine (3 months, **
p < 0.01) improved Abe’s Behavior and Psychological Symptom of
Dementia Score (ABS), respectively. Activities of daily living (ADL) became significantly
worse with galantamine at 12 months ( *
p < 0.05). Male Mini-Mental State Examination scores became worse at
12 months with donepezil ( *
p < 0.05), as did female Geriatric Depression Scale scores at 6
months ( *
p < 0.05). Male HDS-R and ABS scores were preserved in the
galantamine group until 12 months. Female ABS scores with memantine improved at 6 months
( *
p < 0.05), while male ADL scores became worse with rivastigmine at 12
months ( *
p < 0.05).
Conclusion: OLDS revealed that anti-AD drugs were effective even for older
AD patients, and the clinical benefits of each drug showed a small difference with regard
to gender.
