Response to cholinesterase inhibitors affects lifespan in Alzheimer's disease

BMC Neurology

Table 2 Factors that affected the lifespan of AD patients after the start of ChEI treatment (final general linear cognitive and global models)

	*MMSE*		*ADAS-cog*		*CIBIC*
	R = 0.399, R² = 0.159,P < 0.001		R = 0.405, R² = 0.164,P < 0.001		R = 0.365, R² = 0.133,P < 0.001
Significant predictors	β (95% CI)	P value	β (95% CI)	P value	β (95% CI)	P value
Intercept	7.782 (4.742, 10.823)	<0.001	9.796 (6.880, 12.712)	<0.001	9.848 (6.994, 12.702)	<0.001
MMSE or ADAS-cog score at baseline	0.066 (0.008, 0.124)	0.025	-0.031 (-0.055, -0.007)	0.013	na
Change in MMSE or ADAS-cog score after 6 months of ChEI therapy^a	0.072 (0.009, 0.135)	0.025		ns	na
CIBIC score at baseline	na		na		-0.458 (-0.722, -0.195)	0.001
Worsening in CIBIC (score 5-7) after 6 months of ChEI therapy (no = 0, yes = 1)	na		na		-0.502 (-1.001, -0.003)	0.048
Sex (male = 0, female = 1)	0.888 (0.473, 1.302)	<0.001	0.886 (0.467, 1.304)	<0.001	1.029 (0.614, 1.443)	<0.001
Antihypertensive/cardiac therapy (no = 0, yes = 1)	-0.646 (-1.053, -0.239)	0.002	-0.663 (-1.075, -0.252)	0.002	-0.512 (-0.924, -0.100)	0.015
Antidiabetics (no = 0, yes = 1)	-1.563 (-2.537, -0.588)	0.002	-1.627 (-2.607, -0.646)	0.001	-1.614 (-2.578, -0.650)	0.001
Age at first assessment (years)	-0.052 (-0.084, -0.019)	0.002	-0.051 (-0.084, -0.019)	0.002	-0.062 (-0.093, -0.031)	<0.001
Education (years)	-0.104 (-0.189, -0.019)	0.016	-0.104 (-0.189, -0.020)	0.015		ns
IADL score at baseline	-0.070 (-0.113, -0.027)	0.001	-0.074 (-0.117, -0.031)	0.001	na
ChEI dose^b	0.021 (0.009, 0.033)	<0.001	0.023 (0.011, 0.034)	<0.001	0.022 (0.010, 0.034)	<0.001

Apolipoprotein E genotype, solitary living, age at onset, basic ADL ability, number of medications and specific concomitant medications (lipid-lowering agents, estrogens, nonsteroidal anti-inflammatory drugs/acetylsalicylic acid, antidepressants, antipsychotics, and anxiolytics/sedatives/hypnotics) used at the start of ChEI treatment (baseline) were not significant.
β values were unstandardized and are expressed per 1 unit increase for continuous variables, and for the condition present for dichotomous variables.
^aFor clarity, clinical improvements for all scales were calculated as positive changes from baseline.
^bMean percentage of the maximum recommended dose during the first 6 months of ChEI therapy, i.e., 10 mg for donepezil, 12 mg for rivastigmine, and 24 mg for galantamine.
Abbreviations: ADAS-cog Alzheimer's Disease Assessment Scale-cognitive subscale, ChEI cholinesterase inhibitors, CI confidence interval, CIBIC Clinician's Interview-Based Impression of Change, IADL Instrumental Activities of Daily Living, MMSE Mini-Mental State Examination, na not applicable, ns not significant.

ISSN: 1471-2377