Effects of rivastigmine on actigraphically monitored motor activity in severe agitation related to Alzheimer's disease: a placebo-controlled pilot study.

Abstract

Acetylcholinesterase inhibitors (AChEIs) are effective in the treatment of cognitive symptoms in Alzheimer's disease (AD). Because the behavioral and psychological symptoms of dementia (BPSD) have also been attributed to central cholinergic deficits, we examined whether the AChEI rivastigmine can reduce motor activity as measured in a rater-independent manner by wrist actigraphy in agitated AD patients. A total of 20 consecutive AD inpatients (13 females, 7 males, 80.4+/-9.1 years, S.D.) were included from our geriatric psychiatry unit, all of whom were exhibiting agitated behavior not attributable to delirium. Patients were assigned randomly and in a single-blinded fashion to rivastigmine 3mg or placebo for 14 days. Motor activity levels were monitored using an actigraph worn continuously on the wrist of the non-dominant hand. At the beginning and end of the study, patients were assessed using the Neuropsychiatric Inventory (NPI) and Nurses' Observation Scale for Geriatric Patients (NOSGER). Patients in the rivastigmine group exhibited less agitation than placebo recipients on the NPI-agitation subscale, but not on NOSGER. Actigraphic measurements showed a tendency towards reduced motor activity in the rivastigmine group. Because rivastigmine usually exerts its main effects after a longer period of time, the short-term effects seen in our study justify further controlled clinical trials examining the use of rivastigmine in BPSD by means of actigraphy.

• Authors: Richard Mahlberg, Sebastian Walther, Uta Eichmann, Ferenc Tracik, Dieter Kunz
• Journal: Archives of gerontology and geriatrics (Arch Gerontol Geriatr) 2007 Jul-Aug Vol. 45 Issue 1 Pg. 19-26 ISSN: 0167-4943 [Print] Netherlands
• PMID: 16963137 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Cholinesterase Inhibitors
• Phenylcarbamates
• Rivastigmine

Topics

• Aged
• Aged, 80 and over
• Alzheimer Disease (complications, drug therapy, psychology)
• Cholinesterase Inhibitors (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Male
• Monitoring, Physiologic (methods)
• Motor Activity (drug effects, physiology)
• Phenylcarbamates (therapeutic use)
• Pilot Projects
• Psychomotor Agitation (drug therapy, etiology, psychology)
• Rivastigmine
• Severity of Illness Index
• Single-Blind Method
• Treatment Outcome