Acetylcholinesterase Inhibitor in Combination With Cognitive Training in Older Adults

Palo Alto Veterans Affairs Health Care System, Palo Alto, CA, USA.
The Journals of Gerontology Series B Psychological Sciences and Social Sciences (Impact Factor: 3.21). 10/2008; 63(5):P288-94. DOI: 10.1093/geronb/63.5.P288
Source: PubMed


To determine if donepezil, an acetylcholinesterase (AChE) inhibitor, improved the assimilation of cognitive training by older adults with memory complaints, we gave 168 nondemented, community-dwelling volunteers with memory complaints either 5 mg of donepezil (Aricept) or placebo daily for 6 weeks in a randomized, double-blind, placebo-controlled trial. The dosage rose to 10 mg daily for another 6 weeks before a 2-week course of cognitive training and was maintained for the remainder of a year. Cognitive training improved performance; donepezil was well tolerated. However, there were no significant benefits of donepezil compared with placebo. An additional dose-ranging study with a starting dose of 5 mg a day suggests that the high dose was not the reason. Physiological tolerance may occur with chronic donepezil treatment and may increase AChE levels; this may be why short-term studies have shown the benefit of AChE inhibitor use in nondemented participants whereas chronic use has failed to enhance cognition.

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