Effects of acetylcholinesterase inhibitor Donepezil on cognitive function and vital sign in patients with dementia

Maria Yosita Ayu Hapsari, Fathu Thaariq Baihaqy, Muhana Fawwazy Ilyas, Pepi Budianto, Revi Gama Hatta Novika

Abstract


The prevalence of people with dementia is increasing both in Indonesia and throughout the world. Donepezil is one of the dementia therapy options that has been shown to have benefits. This study aims to determine the relationship between the administration of donepezil with cognitive function and vital signs: systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) in patients with dementia. The research was conducted at Dr. Moewardi Hospital (RSDM), Surakarta, Indonesia from September 2021 to February 2022 using a quasi-experimental design with different designs: one-group pretest-posttest design and time-series design. This study followed people with dementia who were given donepezil for 20 weeks. The patient was given donepezil 5 mg daily and scheduled for evaluation by the neurologist every 4 weeks to check vital signs. Cognitive function examination was performed with Mini-Mental State Examination (MMSE) at initial (before drug administration) and final (after 20 weeks). The analytical test included: repeated measures Anova, Friedman alternative, and paired T-test. A total of 27 patients were included in this study. There was an association between the administration of donepezil with cognitive function in patients with dementia at the RSDM (p<0.004). Meanwhile, there was no significant association between the administration of donepezil and vital sign parameters (SBP, DBP, and HR).


Keywords


donepezil; cognitive; vital sign; dementia

References


Knapp M, King D, Romeo R, Adams J, Baldwin A, Ballard C, et al. Cost-effectiveness of donepezil and memantine in moderate to severe Alzheimer’s disease (the DOMINO-AD trial). Int J Geriatr Psychiatry. 2017;32(12):1205–16.

Rini SS, Kuswardhani T, Aryana S. Faktor--faktor yang berhubungan dengan gangguan kognitif pada lansia di Panti Sosial Tresna Werdha Wana Seraya Denpasar. J Penyakit Dalam Udayana. 2018;2(2):32–7.

Martina SE. Caregiver Training On Care For People With Dementia In Medan, North Sumatera. Darmabakti Cendekia J Community Serv Engag. 2020;2(1):1–3.

Dou K-X, Tan M-S, Tan C-C, Cao X-P, Hou X-H, Guo Q-H, et al. Comparative safety and effectiveness of cholinesterase inhibitors and memantine for Alzheimer’s disease: a network meta-analysis of 41 randomized controlled trials. Alzheimer’s Res & Ther. 2018;10(1):1–10.

Zhang N, Gordon ML. Clinical efficacy and safety of donepezil in the treatment of Alzheimer’s disease in Chinese patients. Clin Interv Aging. 2018;13:1963.

Jia J, Wei C, Jia L, Tang Y, Liang J, Zhou A, et al. Efficacy and safety of donepezil in chinese patients with severe alzheimer’s disease: A randomized controlled trial. J Alzheimer’s Dis. 2017;56(4):1495–504.

Isik AT, Soysal P, Usarel C. Effects of acetylcholinesterase inhibitors on balance and gait functions and orthostatic hypotension in elderly patients with Alzheimer disease. Am J Alzheimer’s Dis & Other Dementias®. 2016;31(7):580–4.

Seltzer B. Donepezil: an update. Expert Opin Pharmacother. 2007;8(7):1011–23.

Gust C, Pugliese N, Stern G. Suspected donepezil toxicity: A case report. Clin Case Reports. 2020;8(12):2817–22.

Alamri KNH, Posangi J, Nangoy E. Perbandingan Efektivitas Penggunaan Donepezil dan Memantine Terhadap Perbaikan Fungsi Kognitif pada Penyakit Alzheimer. J Biomedik JBM. 2021;13(2):218–26.

Wilkinson D, Schindler R, Schwam E, Waldemar G, Jones RW, Gauthier S, et al. Effectiveness of donepezil in reducing clinical worsening in patients with mild-to-moderate Alzheimer’s disease. Dement Geriatr Cogn Disord. 2009;28(3):244–51.

Blacker D, Albert MS, Bassett SS, Go RCP, Harrell LE, Folstein MF. Reliability and validity of NINCDS-ADRDA criteria for Alzheimer’s disease: the National Institute of Mental Health Genetics Initiative. Arch Neurol. 1994;51(12):1198–204.

Edition F, others. Diagnostic and statistical manual of mental disorders. Am Psychiatr Assoc. 2013;21(21):591–643.

Rossor MN, Fox NC, Mummery CJ, Schott JM, Warren JD. The diagnosis of young-onset dementia. Lancet Neurol. 2010;9(8):793–806.

Sato K, Urbano R, Yu C, Yamasaki F, Sato T, Jordan J, et al. The effect of donepezil treatment on cardiovascular mortality. Clin Pharmacol & Ther. 2010;88(3):335–8.

Seltzer B, Zolnouni P, Nunez M, Goldman R, Kumar D, Ieni J, et al. Efficacy of donepezil in early-stage Alzheimer disease: a randomized placebo-controlled trial. Arch Neurol. 2004;61(12):1852–6.

Shigeta M, Homma A. Donepezil for Alzheimer’s disease: pharmacodynamic, pharmacokinetic, and clinical profiles. CNS Drug Rev. 2001;7(4):353–68.

Masuda Y, Kawamura A. Acetylcholinesterase inhibitor (donepezil hydrochloride) reduces heart rate variability. J Cardiovasc Pharmacol. 2003;41:S67--S71.

Black S, Román GC, Geldmacher DS, Salloway S, Hecker J, Burns A, et al. Efficacy and tolerability of donepezil in vascular dementia: positive results of a 24-week, multicenter, international, randomized, placebo-controlled clinical trial. Stroke. 2003;34(10):2323–30.


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DOI: 10.24815/jks.v23i1.27558

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