Cholinesterase Inhibitors and Behavioral & Psychological Symptoms of Alzheimer's Disease.

Objective: Examine the effect of cholinesterase inhibitors (ChEIs) on behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD), and compared the dosages of antipsychotics and SSRIs or SNRIs used to treat BPSD in patients with and without ChEIs.

Material And Method: The cross-sectional study of Alzheimer patients who had been taking ChEls for at least six months (ChEI+) or had never been on any ChEIs (ChEI-) were enrolled from the Memory Clinic, Ramathibodi hospital between September 1, 2014 and February 28, 2015. All of these patients were evaluated with Mini-Mental Status Exam (MMSE) for cognitive function, Neuropsychiatric Inventory-Questionnaire (NPI-Q) for BPSD, and psychotropic dosage used.

Results: Fifty-one Alzheimer patients were enrolled, 31 patients in the ChEI+ group and 20 patients in the ChEI- group. Mean and SD of MMSEs in ChEI+ and ChEI- were 13.6 ± 1.2 and 11.75 ± 1.4, respectively (p-value = 0.33). The Mean and SD of NPI scores in ChEI+ and ChEI- were 15.68 ± 14.31 and 19.5 ± 20.1, respectively (p-value = 0.43). Patients in ChEI + had tend to had a lower depression severity score (p = 0.10) and lower burden from aggression/agitation (p = 0.08). The differences were not statistically signifcant. Mean highest dosages per day (olanzapine equivalence) in the ChEI+ and ChEI- were 1.6 mg and 3.1 mg, respectively (p-value = 0.07).

Conclusion: The total off NPI score between the ChEI+ and ChEI- groups were not different, but there were report the trends toward lower depression severity score, aggression/agitation distress score, and antipsychotic dosages use in the ChEI+.