Donepezil delays progression to AD in MCI subjects with depressive symptoms

P. H. Lu, S. D. Edland, E. Teng, K. Tingus, Ronald Carl Petersen, J. L. Cummings

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

OBJECTIVE: To determine whether the presence of depression predicts higher rate of progression to Alzheimer disease (AD) in patients with amnestic mild cognitive impairment (aMCI) and whether donepezil treatment beneficially affect this relationship. METHODS: The study sample was composed of 756 participants with aMCI from the 3-year, double-blind, placebo-controlled Alzheimer's Disease Cooperative Study drug trial of donepezil and vitamin E. Beck Depression Inventory (BDI) was used to assess depressive symptoms at baseline and participants were followed either to the end of study or to the primary endpoint of progression to probable or possible AD. RESULTS: Cox proportional hazards regression, adjusted for age at baseline, gender, apolipoprotein genotype, and NYU paragraph delayed recall score, showed that higher BDI scores were associated with progression to AD (p = 0.03). The sample was stratified into depressed (BDI score ≥ n = 208) and nondepressed (BDI <10; n = 548) groups. Kaplan-Meier analysis showed that among the depressed subjects, the proportion progressing to AD was lower for the donepezil group than the combined vitamin E and placebo groups at 1.7 years (p ≤ 0.023), at 2.2 years (p = 0.025), and remained marginally lower at 2.7 years (p = 0.070). The survival curves among the three treatment groups did not differ within the nondepressed participants. CONCLUSIONS: Results suggest that depression is predictive of progression from amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD) and treatment with donepezil delayed progression to AD among depressed subjects with aMCI. Donepezil appears to modulate the increased risk of AD conferred by the presence of depressive symptoms.

Original languageEnglish (US)
Pages (from-to)2115-2121
Number of pages7
JournalNeurology
Volume72
Issue number24
DOIs
StatePublished - Jun 16 2009

Fingerprint

Alzheimer Disease
Depression
Equipment and Supplies
Vitamin E
Placebos
donepezil
Apolipoproteins
Kaplan-Meier Estimate
Therapeutics
Genotype
Survival
Cognitive Dysfunction
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Lu, P. H., Edland, S. D., Teng, E., Tingus, K., Petersen, R. C., & Cummings, J. L. (2009). Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology, 72(24), 2115-2121. https://doi.org/10.1212/WNL.0b013e3181aa52d3

Donepezil delays progression to AD in MCI subjects with depressive symptoms. / Lu, P. H.; Edland, S. D.; Teng, E.; Tingus, K.; Petersen, Ronald Carl; Cummings, J. L.

In: Neurology, Vol. 72, No. 24, 16.06.2009, p. 2115-2121.

Research output: Contribution to journalArticle

Lu, PH, Edland, SD, Teng, E, Tingus, K, Petersen, RC & Cummings, JL 2009, 'Donepezil delays progression to AD in MCI subjects with depressive symptoms', Neurology, vol. 72, no. 24, pp. 2115-2121. https://doi.org/10.1212/WNL.0b013e3181aa52d3
Lu, P. H. ; Edland, S. D. ; Teng, E. ; Tingus, K. ; Petersen, Ronald Carl ; Cummings, J. L. / Donepezil delays progression to AD in MCI subjects with depressive symptoms. In: Neurology. 2009 ; Vol. 72, No. 24. pp. 2115-2121.
@article{d10c75d2b85445e488a37fcbec2abe88,
title = "Donepezil delays progression to AD in MCI subjects with depressive symptoms",
abstract = "OBJECTIVE: To determine whether the presence of depression predicts higher rate of progression to Alzheimer disease (AD) in patients with amnestic mild cognitive impairment (aMCI) and whether donepezil treatment beneficially affect this relationship. METHODS: The study sample was composed of 756 participants with aMCI from the 3-year, double-blind, placebo-controlled Alzheimer's Disease Cooperative Study drug trial of donepezil and vitamin E. Beck Depression Inventory (BDI) was used to assess depressive symptoms at baseline and participants were followed either to the end of study or to the primary endpoint of progression to probable or possible AD. RESULTS: Cox proportional hazards regression, adjusted for age at baseline, gender, apolipoprotein genotype, and NYU paragraph delayed recall score, showed that higher BDI scores were associated with progression to AD (p = 0.03). The sample was stratified into depressed (BDI score ≥ n = 208) and nondepressed (BDI <10; n = 548) groups. Kaplan-Meier analysis showed that among the depressed subjects, the proportion progressing to AD was lower for the donepezil group than the combined vitamin E and placebo groups at 1.7 years (p ≤ 0.023), at 2.2 years (p = 0.025), and remained marginally lower at 2.7 years (p = 0.070). The survival curves among the three treatment groups did not differ within the nondepressed participants. CONCLUSIONS: Results suggest that depression is predictive of progression from amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD) and treatment with donepezil delayed progression to AD among depressed subjects with aMCI. Donepezil appears to modulate the increased risk of AD conferred by the presence of depressive symptoms.",
author = "Lu, {P. H.} and Edland, {S. D.} and E. Teng and K. Tingus and Petersen, {Ronald Carl} and Cummings, {J. L.}",
year = "2009",
month = "6",
day = "16",
doi = "10.1212/WNL.0b013e3181aa52d3",
language = "English (US)",
volume = "72",
pages = "2115--2121",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "24",

}

TY - JOUR

T1 - Donepezil delays progression to AD in MCI subjects with depressive symptoms

AU - Lu, P. H.

AU - Edland, S. D.

AU - Teng, E.

AU - Tingus, K.

AU - Petersen, Ronald Carl

AU - Cummings, J. L.

PY - 2009/6/16

Y1 - 2009/6/16

N2 - OBJECTIVE: To determine whether the presence of depression predicts higher rate of progression to Alzheimer disease (AD) in patients with amnestic mild cognitive impairment (aMCI) and whether donepezil treatment beneficially affect this relationship. METHODS: The study sample was composed of 756 participants with aMCI from the 3-year, double-blind, placebo-controlled Alzheimer's Disease Cooperative Study drug trial of donepezil and vitamin E. Beck Depression Inventory (BDI) was used to assess depressive symptoms at baseline and participants were followed either to the end of study or to the primary endpoint of progression to probable or possible AD. RESULTS: Cox proportional hazards regression, adjusted for age at baseline, gender, apolipoprotein genotype, and NYU paragraph delayed recall score, showed that higher BDI scores were associated with progression to AD (p = 0.03). The sample was stratified into depressed (BDI score ≥ n = 208) and nondepressed (BDI <10; n = 548) groups. Kaplan-Meier analysis showed that among the depressed subjects, the proportion progressing to AD was lower for the donepezil group than the combined vitamin E and placebo groups at 1.7 years (p ≤ 0.023), at 2.2 years (p = 0.025), and remained marginally lower at 2.7 years (p = 0.070). The survival curves among the three treatment groups did not differ within the nondepressed participants. CONCLUSIONS: Results suggest that depression is predictive of progression from amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD) and treatment with donepezil delayed progression to AD among depressed subjects with aMCI. Donepezil appears to modulate the increased risk of AD conferred by the presence of depressive symptoms.

AB - OBJECTIVE: To determine whether the presence of depression predicts higher rate of progression to Alzheimer disease (AD) in patients with amnestic mild cognitive impairment (aMCI) and whether donepezil treatment beneficially affect this relationship. METHODS: The study sample was composed of 756 participants with aMCI from the 3-year, double-blind, placebo-controlled Alzheimer's Disease Cooperative Study drug trial of donepezil and vitamin E. Beck Depression Inventory (BDI) was used to assess depressive symptoms at baseline and participants were followed either to the end of study or to the primary endpoint of progression to probable or possible AD. RESULTS: Cox proportional hazards regression, adjusted for age at baseline, gender, apolipoprotein genotype, and NYU paragraph delayed recall score, showed that higher BDI scores were associated with progression to AD (p = 0.03). The sample was stratified into depressed (BDI score ≥ n = 208) and nondepressed (BDI <10; n = 548) groups. Kaplan-Meier analysis showed that among the depressed subjects, the proportion progressing to AD was lower for the donepezil group than the combined vitamin E and placebo groups at 1.7 years (p ≤ 0.023), at 2.2 years (p = 0.025), and remained marginally lower at 2.7 years (p = 0.070). The survival curves among the three treatment groups did not differ within the nondepressed participants. CONCLUSIONS: Results suggest that depression is predictive of progression from amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD) and treatment with donepezil delayed progression to AD among depressed subjects with aMCI. Donepezil appears to modulate the increased risk of AD conferred by the presence of depressive symptoms.

UR - http://www.scopus.com/inward/record.url?scp=67649488056&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67649488056&partnerID=8YFLogxK

U2 - 10.1212/WNL.0b013e3181aa52d3

DO - 10.1212/WNL.0b013e3181aa52d3

M3 - Article

C2 - 19528519

AN - SCOPUS:67649488056

VL - 72

SP - 2115

EP - 2121

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 24

ER -