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  • Title: Changes in cognitive functions of patients with dementia of the Alzheimer type following long-term administration of donepezil hydrochloride: relating to changes attributable to differences in apolipoprotein E phenotype.
    Author: Kanaya K, Abe S, Sakai M, Fujii H, Iwamoto T.
    Journal: Geriatr Gerontol Int; 2010 Jan; 10(1):25-31. PubMed ID: 20102379.
    Abstract:
    AIM: We conducted a study of changes in cognitive functions by long-term monitoring of dementia of Alzheimer type (DAT) patients to investigate the relationship between the progression of DAT symptoms and the presence of apolipoprotein (ApoE)4. METHODS: The subjects consisted of 40 DAT patients who had been treated with donepezil for 3 years or more. The Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale - Cognitive Subscale Japanese version (ADAS-Jcog), were conducted annually. The patients were categorized into ApoE4(+) and ApoE4(-) groups. Changes in initial cognitive function assessment score (0 years) were then studied longitudinally at each stage of the observation period (1, 2, 3 years) (Wilcoxon's signed-rank test). Moreover, the scores at each time period were compared cross-sectionally between the two groups (Mann-Whitney U-test). RESULTS: Significant decreases in MMSE scores were observed at the three time periods in both groups (P < 0.01) in the cross-sectional study. In the longitudinal study, the ApoE4(+) group demonstrated a lower trend (P < 0.1) after 1 year only. Significantly poorer ADAS-Jcog scores were observed in the ApoE4(+) group at the 3-year point both in the longitudinal and in the cross-sectional study (P < 0.05). For ADAS-Jcog sub-items, in the longitudinal study, orientation was demonstrated to be significantly poorer in the ApoE4(+) group in the third year (P < 0.05). CONCLUSION: ApoE4 was suggested to not only be a risk factor for disease onset, but also a risk factor for exacerbation of symptoms with respect to long-term prognosis.
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