Long-term tacrine (Cognex) treatment: Effects on nursing home placement and mortality

David S Knopman, L. Schneider, K. Davis, S. Talwalker, F. Smith, T. Hoover, S. Gracon

Research output: Contribution to journalArticle

330 Citations (Scopus)

Abstract

Objective: To assess the possible association between tacrine (Cognex, manufactured by Parke-Davis, Morris Plains, NJ) dose and likelihood of nursing home placement (NHP) or death in patients with AD. Design: A 30- week, randomized, double-blind, placebo-controlled, parallel-group multicenter clinical trial involving 663 patients, after which patients were treated openly and followed up a minimum of 2 years later. Patients: At baseline, outpatients were at least 50 years of age, met criteria for probable AD, with baseline Mini-Mental State Examination scores between 10 and 26 (inclusive), were otherwise healthy, and had a caregiver who could provide assessments and ensure medication compliance. Interventions: Randomized assignment to placebo or one of three ascending dosage regimens of tacrine over 30 weeks, followed by open label treatment for all patients who began the double-blind trial. Outcome Measures: NHP and death were examined using logistic regression. Results: Patients who remained on tacrine and were receiving doses > 80 mg/d or > 120 mg/d were less likely to have entered a nursing home than patients on lower doses (odds ratios > 2.7, 2.8, respectively.) There was a trend for lower mortality for patients receiving > 120 mg/d (p = 0.063). Conclusions: Treatment with tacrine at doses > 80 mg/d was associated with a reduced likelihood of NHP. These data demonstrate that tacrine's 30-week effects on cognitive function and clinicians' global ratings may generalize to effects on a major milestone of AD. Future studies should attempt to replicate these findings prospectively.

Original languageEnglish (US)
Pages (from-to)166-177
Number of pages12
JournalNeurology
Volume47
Issue number1
StatePublished - Jul 1996
Externally publishedYes

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Tacrine
Nursing Homes
Mortality
Therapeutics
Placebos
Medication Adherence
Cognition
Caregivers
Multicenter Studies
Outpatients
Logistic Models
Odds Ratio
Outcome Assessment (Health Care)
Clinical Trials

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Knopman, D. S., Schneider, L., Davis, K., Talwalker, S., Smith, F., Hoover, T., & Gracon, S. (1996). Long-term tacrine (Cognex) treatment: Effects on nursing home placement and mortality. Neurology, 47(1), 166-177.

Long-term tacrine (Cognex) treatment : Effects on nursing home placement and mortality. / Knopman, David S; Schneider, L.; Davis, K.; Talwalker, S.; Smith, F.; Hoover, T.; Gracon, S.

In: Neurology, Vol. 47, No. 1, 07.1996, p. 166-177.

Research output: Contribution to journalArticle

Knopman, DS, Schneider, L, Davis, K, Talwalker, S, Smith, F, Hoover, T & Gracon, S 1996, 'Long-term tacrine (Cognex) treatment: Effects on nursing home placement and mortality', Neurology, vol. 47, no. 1, pp. 166-177.
Knopman DS, Schneider L, Davis K, Talwalker S, Smith F, Hoover T et al. Long-term tacrine (Cognex) treatment: Effects on nursing home placement and mortality. Neurology. 1996 Jul;47(1):166-177.
Knopman, David S ; Schneider, L. ; Davis, K. ; Talwalker, S. ; Smith, F. ; Hoover, T. ; Gracon, S. / Long-term tacrine (Cognex) treatment : Effects on nursing home placement and mortality. In: Neurology. 1996 ; Vol. 47, No. 1. pp. 166-177.
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