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ABSTRACT: Analysis of views of general practioners and nurses of interprofessional cooperation between general practititoners and nurses in the ambulatory care of dementia patients is presented.A survey was carried out among general practitioners and nurses caring for community dwelling dementia patients in Hamburg.The majority of GPs and nurses consider interprofessional cooperation to be good and beneficial for their own work. GPs are generally more positive about the quality of cooperation than nurses. Joint sessions for planning and evaluation of care are seldom. Even so, more GPs than nurses evaluate the frequency of these meetings to be sufficient. Although nurses are more critical about the quality of the cooperation with the GPs, they seldom address the GP to express their criticism.To make cooperation work, the matter should be part of the training of both physicians and nurses and the hierarchy between the 2 groups should be reduced.
Das Gesundheitswesen 08/2012; · 0.94 Impact Factor
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T. Luck,
S.G. Riedel-Heller,
B. Wiese,
J. Stein,
S. Weyerer,
J. Werle,
H. Kaduszkiewicz,
M. Wagner,
E. Mösch,
T. Zimmermann,
W. Maier,
H. Bickel, H. van den Bussche,
F. Jessen,
A. Fuchs,
M. Pentzek,
für die AgeCoDe Study Group
[show abstract]
[hide abstract]
ABSTRACT: Mit der CERAD-NP-Testbatterie liegen gut etablierte Verfahren zur neuropsychologischen Diagnostik charakteristischer kognitiver
Defizite einer Demenz vom Alzheimer-Typ vor. Die Anwendbarkeit neuropsychologischer Verfahren setzt das Vorhandensein zuverlässiger
Normwerte für die zugrunde liegende Population unter Berücksichtigung soziodemographischer Faktoren wie Alter, Bildung und
Geschlecht voraus. In der vorliegenden Arbeit wurden alters- bildungs- und geschlechtsspezifische Normwerte (Prozentränge
und T-Werte bzw. Perzentile) für die Subtests Verbale Flüssigkeit, Wortliste Gedächtnis, Wortliste Abrufen und Wortliste Wiedererkennen sowie den Wortliste-Savings-Score der CERAD-NP-Testbatterie an einer Stichprobe von 2891 älteren (75Jahre und darüber) nichtdementen Hausarztpatienten aus
Deutschland ermittelt. Die Probanden hatten ein Durchschnittsalter von 80,2Jahren (SD=3,6); somit bietet dieser Beitrag zuverlässige
Normwerte für die neuropsychologische Demenzdiagnostik in den höheren Altersgruppen an.
The CERAD-NP battery represents well-established tests for the neuropsychological diagnosis of characteristic cognitive deficits
in Alzheimer’s dementia. However, the use of neuropsychological tests requires reliable standard values for the population
under consideration, taking sociodemographic characteristics like age, education and gender into account. This report presents
age-, education- and gender-specific reference values for the subtests verbal fluency, word list memory, word list recall and word list recognition as well as the word list savings score of the CERAD-NP battery. The study sample consists of 2891 general practitioners’ patients from Germany aged 75years and
older. The study participants had a mean age of 80.2years (SD=3.6); thus, this report provides reliable reference values
for the neuropsychological diagnosis of dementia in older age groups.
SchlüsselwörterCERAD-CERAD-NP-Testbatterie-Neuropsychologische Diagnostik-Normen-Alzheimer-Demenz
KeywordsCERAD-CERAD-NP battery-Neuropsychological assessment-Norms-Alzheimer’s dementia
Zeitschrift für Gerontologie + Geriatrie 04/2012; 42(5):372-384. · 0.61 Impact Factor
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Hanna Kaduszkiewicz,
T. Zimmermann, H. van Den Bussche,
C. Bachmann,
B. Wiese,
H. Bickel,
E. Mösch,
H. -P. Romberg,
F. Jessen,
G. Cvetanovska-Pllashniku,
W. Maier,
S. G. Riedel-Heller,
M. Luppa,
H. Sandholzer,
S. Weyerer,
M. Mayer,
A. Hofmann,
A. Fuchs,
H.-H. Abholz,
M. Pentzek
[show abstract]
[hide abstract]
ABSTRACT: ObjectivesThe need for recognition of mild cognitive impairment (MCI) in primary care is increasingly discussed because MCI is a risk
factor for dementia. General Practitioners (GPs) could play an important role in the detection of MCI since they have regular
and long-term contact with the majority of the elderly population. Thus the objective of this study is to find out how well
GPs recognize persons with MCI in their practice population.
DesignCross-sectional study.
SettingPrimary care chart registry sample.
Participants3,242 non-demented GP patients aged 75–89 years.
MeasurementsGPs assessed the cognitive status of their patients on the Global Deterioration Scale (GDS). Thereafter, trained interviewers
collected psychometric data by interviewing the patients at home. The interview data constitute the basis for the definition
of MCI cases (gold standard).
ResultsThe sensitivity of GPs to detect MCI was very low (11–12%) whereas their specificity amounts to 93–94%. Patients with MCI
with a middle or high level of education more often got a false negative assignment than patients with a low educational level.
The risk of a false positive assignment rose with the patients’ degree of comorbidity. GPs were better at detecting MCI when
memory or two and more MCIdomains were impaired.
ConclusionThe results show that GPs recognise MCI in a very limited number of cases when based on clinical impression only. A further
development of the MCI concept and its operationalisation is necessary. Emphasis should be placed on validated, reliable and
standardised tests for routine use in primary care encompassing other than only cognitive domains and on case finding approaches
rather than on screening. Then a better attention and qualification of GPs with regard to the recognition of MCI might be
achievable.
Key wordsMild cognitive impairment-recognition-primary care-early detection-dementia
The Journal of Nutrition Health and Aging 04/2012; 14(8):697-702. · 2.69 Impact Factor
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H Leicht,
S Heinrich,
D Heider,
C Bachmann,
H Bickel, H van den Bussche,
A Fuchs,
M Luppa,
W Maier,
E Mösch,
M Pentzek,
S G Rieder-Heller,
F Tebarth,
J Werle,
S Weyerer,
B Wiese,
T Zimmermann,
H-H König
[show abstract]
[hide abstract]
ABSTRACT: To estimate net costs of dementia by degree of severity from a societal perspective, including a detailed assessment of costs of formal and informal nursing care.
In a cross-sectional study, costs of illness were analysed in 176 dementia patients and 173 matched non-demented control subjects. Healthcare resource use and costs were assessed retrospectively by means of a questionnaire. Dementia patients were classified into three disease stages, and linear regression models were applied to estimate net costs of dementia by degree of severity.
Annual net costs of dementia by stage were approximately €15 000 (mild), €32 000 (moderate) and €42 000 (severe), corresponding to US-$21 450, 45 760 and 60 060 respectively. Across disease stages, nursing care accounted for approximately three-quarters of total costs, of which half resulted from informal care. In sensitivity analyses using different valuation methods for nursing care, total costs decreased or increased by more than 20%.
Net costs more than double across stages of dementia. Informal care accounts for a considerable share of nursing care costs, and the approach to valuation of informal care has a large impact on cost-of-illness estimates.
Acta Psychiatrica Scandinavica 08/2011; 124(5):384-95. · 4.22 Impact Factor
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A Papassotiropoulos,
K Henke,
E Stefanova,
A Aerni,
A Müller,
P Demougin,
C Vogler,
J C Sigmund,
L Gschwind,
K-D Huynh, [......],
S Weyerer,
H Bickel,
S Riedel-Heller,
M Pentzek,
B Wiese,
M Dichgans,
M Wagner,
F Jessen,
W Maier,
D J-F de Quervain
[show abstract]
[hide abstract]
ABSTRACT: Recent advances in the development of high-throughput genotyping platforms allow for the unbiased identification of genes and genomic sequences related to heritable traits. In this study, we analyzed human short-term memory, which refers to the ability to remember information over a brief period of time and which has been found disturbed in many neuropsychiatric conditions, including schizophrenia and depression. We performed a genome-wide survey at 909 622 polymorphic loci and report six genetic variations significantly associated with human short-term memory performance after genome-wide correction for multiple comparisons. A polymorphism within SCN1A (encoding the α subunit of the type I voltage-gated sodium channel) was replicated in three independent populations of 1699 individuals. Functional magnetic resonance imaging during an n-back working memory task detected SCN1A allele-dependent activation differences in brain regions typically involved in working memory processes. These results suggest an important role for SCN1A in human short-term memory.
Molecular Psychiatry 02/2011; 16(2):184-92. · 13.67 Impact Factor
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T. Luck,
S. G. Riedel-Heller,
M. Luppa,
B. Wiese,
A. Wollny,
M. Wagner,
H. Bickel,
S. Weyerer,
M. Pentzek,
F. Haller,
E. Moesch,
J. Werle,
M. Eisele,
W. Maier, H. Van Den Bussche,
H. Kaduszkiewicz,
for the AgeCoDe Study Group
[show abstract]
[hide abstract]
ABSTRACT: Luck T, Riedel-Heller SG, Luppa M, Wiese B, Wollny A, Wagner M, Bickel H, Weyerer S, Pentzek M, Haller F, Moesch E, Werle J, Eisele M, Maier W, van den Bussche H, Kaduszkiewicz H for the AgeCoDe Study Group. Risk factors for incident mild cognitive impairment – results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe).Objectives: To provide age- and gender-specific incidence rates of MCI among elderly general practitioner (GP) patients (75+ years) and to identify risk factors for incident MCI.Method: Data were derived from the longitudinal German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Incidence was calculated according to the ‘person-years-at-risk’ method. Risk factors were analysed using multivariate logistic regression models.Results: During the 3-year follow-up period, 350 (15.0%) of the 2331 patients whose data were included in the calculation of incidence developed MCI [person-years (PY) = 6198.20]. The overall incidence of MCI was 56.5 (95% confidence interval = 50.7–62.7) per 1000 PY. Older age, vascular diseases, the apoE ε4 allele and subjective memory complaints were identified as significant risk factors for future MCI.Conclusion: Mild cognitive impairment is frequent in older GP patients. Subjective memory complaints predict incident MCI. Especially vascular risk factors provide the opportunity of preventive approaches.
Acta Psychiatrica Scandinavica 03/2010; 121(4):260 - 272. · 4.22 Impact Factor
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H Kaduszkiewicz,
T Zimmermann, H Van den Bussche,
C Bachmann,
B Wiese,
H Bickel,
E Mösch,
H-P Romberg,
F Jessen,
G Cvetanovska-Pllashniku,
W Maier,
S G Riedel-Heller,
M Luppa,
H Sandholzer,
S Weyerer,
M Mayer,
A Hofmann,
A Fuchs,
H-H Abholz,
M Pentzek
[show abstract]
[hide abstract]
ABSTRACT: The need for recognition of mild cognitive impairment (MCI) in primary care is increasingly discussed because MCI is a risk factor for dementia. General Practitioners (GPs) could play an important role in the detection of MCI since they have regular and long-term contact with the majority of the elderly population. Thus the objective of this study is to find out how well GPs recognize persons with MCI in their practice population.
Cross-sectional study.
Primary care chart registry sample.
3,242 non-demented GP patients aged 75-89 years.
GPs assessed the cognitive status of their patients on the Global Deterioration Scale (GDS). Thereafter, trained interviewers collected psychometric data by interviewing the patients at home. The interview data constitute the basis for the definition of MCI cases (gold standard).
The sensitivity of GPs to detect MCI was very low (11-12%) whereas their specificity amounts to 93-94%. Patients with MCI with a middle or high level of education more often got a false negative assignment than patients with a low educational level. The risk of a false positive assignment rose with the patients' degree of comorbidity. GPs were better at detecting MCI when memory or two and more MCI-domains were impaired.
The results show that GPs recognise MCI in a very limited number of cases when based on clinical impression only. A further development of the MCI concept and its operationalisation is necessary. Emphasis should be placed on validated, reliable and standardised tests for routine use in primary care encompassing other than only cognitive domains and on case finding approaches rather than on screening. Then a better attention and qualification of GPs with regard to the recognition of MCI might be achievable.
The Journal of Nutrition Health and Aging 01/2010; 14(8):697-702. · 2.69 Impact Factor
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A Papassotiropoulos,
K Henke,
E Stefanova,
A Aerni,
A M|[uuml]|ller,
P Demougin,
C Vogler,
J C Sigmund,
L Gschwind,
K-D Huynh, [......],
S Weyerer,
H Bickel,
S Riedel-Heller,
M Pentzek,
B Wiese,
M Dichgans,
M Wagner,
F Jessen,
W Maier,
D J-F de Quervain
[show abstract]
[hide abstract]
ABSTRACT: Recent advances in the development of high-throughput genotyping platforms allow for the unbiased identification of genes and genomic sequences related to heritable traits. In this study, we analyzed human short-term memory, which refers to the ability to remember information over a brief period of time and which has been found disturbed in many neuropsychiatric conditions, including schizophrenia and depression. We performed a genome-wide survey at 909 622 polymorphic loci and report six genetic variations significantly associated with human short-term memory performance after genome-wide correction for multiple comparisons. A polymorphism within SCN1A (encoding the α subunit of the type I voltage-gated sodium channel) was replicated in three independent populations of 1699 individuals. Functional magnetic resonance imaging during an n-back working memory task detected SCN1A allele-dependent activation differences in brain regions typically involved in working memory processes. These results suggest an important role for SCN1A in human short-term memory.Keywords: SCN1A; sodium channel; memory; functional brain imaging; fMRI; GWAS
Molecular Psychiatry 12/2009; 16(2):184-192. · 13.67 Impact Factor
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T Luck,
S G Riedel-Heller,
B Wiese,
J Stein,
S Weyerer,
J Werle,
H Kaduszkiewicz,
M Wagner,
E Mösch,
T Zimmermann,
W Maier,
H Bickel, H van den Bussche,
F Jessen,
A Fuchs,
M Pentzek
[show abstract]
[hide abstract]
ABSTRACT: The CERAD-NP battery represents well-established tests for the neuropsychological diagnosis of characteristic cognitive deficits in Alzheimer's dementia. However, the use of neuropsychological tests requires reliable standard values for the population under consideration, taking sociodemographic characteristics like age, education and gender into account. This report presents age-, education- and gender-specific reference values for the subtests verbal fluency, word list memory, word list recall and word list recognition as well as the word list savings score of the CERAD-NP battery. The study sample consists of 2891 general practitioners' patients from Germany aged 75 years and older. The study participants had a mean age of 80.2 years (SD=3.6); thus, this report provides reliable reference values for the neuropsychological diagnosis of dementia in older age groups.
Zeitschrift für Gerontologie + Geriatrie 08/2009; 42(5):372-84. · 0.61 Impact Factor
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D. Harold,
R. Abraham,
P. Hollingworth,
R. Sims,
A. Gerrish,
M. L. Hamshere,
J. S. Pahwa,
V. Moskvina,
K. Dowzell,
A. Williams, [......],
K. H. Jockel,
N. Klopp,
H. E. Wichmann,
M. M. Carrasquillo,
V. S. Pankratz,
S. G. Younkin,
P. A. Holmans,
M. O'Donovan,
M. J. Owen,
J. Williams
Nat Genet. 01/2009; 41(10):1156.
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[show abstract]
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ABSTRACT: Stroke is the archetype of a chronic disease, with a considerable burden on ambulatory care. After discharge from hospital or inpatient rehabilitation, stroke patients are attended primarily by general practitioners (GPs). Little is known about the quality of outpatient care for stroke patients, so this study focused on the views of professionals involved in outpatient care.
A postal survey of 443 general practitioners from Hamburg, Germany was undertaken. Results were compared with a parallel survey carried out with physiotherapists and occupational therapists.
89 questionnaires were analysed. Based on a response rate of 28% the results cannot be seen as representative, but they do provide important information. As it seems, problems in ambulatory care do not start after discharge from hospital, but are partly caused by inpatient care. GPs see therapeutic benefits in ambulatory care for only half of their chronic stroke patients. They assess their own therapeutic efforts as effective in terms of medication, but they are less successful in changing their patients' behaviour with regard to lifestyle. Estimations of the prevalence of post-stroke depression vary substantially, with a mean of 47%. With regard to their daily practice, 60% of GPs do not find guidelines to be helpful. All in all, respondents describe the situation of chronic stroke patients and their families to be complex and difficult to manage. In addition to their professional performance, GPs carry out duties related to case management - as do the therapists.
The care of stroke patients is not only the responsibility of a single group of professionals, but is a rather complex task involving different health-care professionals. The rehabilitation process and the interdisciplinary cooperation need to be further analysed to ensure a good cooperation between health-care professionals and to improve the quality of ambulatory care for stroke patients.
Das Gesundheitswesen 04/2008; 70(3):170-6. · 0.94 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: The disease management programme for diabetes mellitus type 2 (DMP) is joined by many General Practitioners. Aim of the study is to compare patients included in this programme with patients not included and to explore reasons for the selection.
10 GPs in Hamburg participated. From each patient list 10 participants in the DMP and the same number of non-participants were randomly selected. HbA1c before start of the programme, presence of insulin therapy, comorbidity and language skills were documented. GPs reported their estimation of the compliance and their reasoning in the selection process. The hypothesis for the primary endpoint was: Diabetics not included have a worse HbA1c value than those included in the DMP.
The hypothesis was not confirmed. In both groups similarly good HbA1c values were observed (7.0 in DMP participants, 7.3 in non-participants). The included participants differed from those not included with respect to age (statistically significantly younger) and a better compliance. In the subgroup of patients younger than 70 years the patients included have a better HbA1c and get insulin more frequently (both n. s.).
One part of the patients seems to be not included into the DMP for good reasons. Two questions should be further evaluated: To what extent are patients included although they already have a good metabolic situation? And to what extent are patients with a poor compliance not included, although they might benefit from participation?
Das Gesundheitswesen 06/2006; 68(5):289-93. · 0.94 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: Three examples serve to highlight challenges for health care that stem from population ageing and the health situation of the elderly. The first challenge is to develop and evaluate prevention and health promotion programmes for the elderly. Two promising interventions are outlined: 'preventive home visits' and 'active health promotion in old age'. The second challenge is to improve the coordination of health and social care measures. Case management is presented as one adequate approach in this regard. The third challenge stems from the increasing prevalence of age-specific diseases. In terms of dementia it is pointed out that it is important to improve early diagnosis and to integrate self-help groups and counselling services into therapy.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 03/2006; 49(2):167-74. · 0.66 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: of the study was to seize the attitudes of General Practitioners (GPs) towards the disease management program (DMP) for type 2 diabetes implemented in summer 2003 in Germany. Moreover we were interested in the way GPs realise the program in daily practice, e. g. how many patients and which patients they include.
A postal questionnaire was sent twice to all GPs in the region of Hamburg (n = 1.230), in November 2003 and in December 2004. Response rate without reminder was 20 respective 16 percent.
In 2004 81 percent of the GPs taking part in the survey participate in the DMP. These doctors include a third of their patients with type 2 diabetes into the program. 65 percent of the GPs nevertheless do not believe, that the patients will benefit from the program. 47 percent of the participating GPs object to DMP in general. Only 66 percent say they follow the DMP guidelines for pharmacotherapy. Half of the doctors state they actively canvass patients for the program, while one fifth says they advice patients against participation. The GPs participate in first line to supply the demand of the patients and because of the public pressure less because they think the DMP is good in respect of content. In 2003 critics and pessimism regarding benefit for patients were even stronger than in 2004. Conclusions: GPs participate in the DMP diabetes half-heartedly and with doubts. The results suggest selections in the inclusion of patients. Further research should find out whether patients being likely to profit from the DMP are systematically not included.
Das Gesundheitswesen 02/2006; 68(1):26-31. · 0.94 Impact Factor
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ABSTRACT: Anhand dreier Beispiele werden Herausforderungen fr die gesundheitliche Versorgung aufgezeigt, die sich aus der demografischen Alterung und der gesundheitlichen Situation lterer Menschen ergeben. Die erste Herausforderung besteht in einer Intensivierung der Prvention und Gesundheitsfrderung im hheren Lebensalter. Hier werden vor allem 2Erfolg versprechende Programme skizziert: prventive Hausbesuche und aktive Gesundheitsfrderung im Alter. Die zweite Herausforderung besteht in einer bedrfnisgerechten Koordination und Vernetzung von Versorgungsleistungen. Als mglicher Ansatzpunkt wird in diesem Zusammenhang das Konzept des Case Managements dargestellt. Drittens ergeben sich Herausforderungen durch die zunehmende Prvalenz bestimmter Erkrankungen. In Bezug auf die Demenz wird herausgearbeitet, dass diese in einer verbesserten Frhdiagnose und in einer verstrkten Integration von Selbsthilfegruppen und spezialisierten Beratungsstellen in die Behandlung bestehen.Three examples serve to highlight challenges for health care that stem from population ageing and the health situation of the elderly. The first challenge is to develop and evaluate prevention and health promotion programmes for the elderly. Two promising interventions are outlined: preventive home visits and active health promotion in old age. The second challenge is to improve the coordination of health and social care measures. Case management is presented as one adequate approach in this regard. The third challenge stems from the increasing prevalence of age-specific diseases. In terms of dementia it is pointed out that it is important to improve early diagnosis and to integrate self-help groups and counselling services into therapy.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2006; 49(2):167-174. · 0.66 Impact Factor
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H van den Bussche
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[hide abstract]
ABSTRACT: The paper reviews the evidence for the recommendation of cholinesterase inhibitors and asks critical questions concerning the reasons for the discrepancy between the weak evidence and the recommendation of these drugs in therapy guidelines. Furthermore, the argument of the severe underuse of these drugs is examined.
Zeitschrift für Gerontologie + Geriatrie 10/2005; 38 Suppl 1:I18-20. · 0.61 Impact Factor
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ABSTRACT: Until very recently, medicine in old age was not an obligatory part of the medical students' education in Germany. This has been changed by an educational reform. However, there are no obliging recommendations or procedures on which issues of medicine in old age should be taught. Therefore, we describe the development of a new curriculum, first experiences with the teaching, and the results of its evaluation by the students at the University of Hamburg. As a result, the subjects and the didactic teaching were both well accepted by the students and judged as interesting and instructive.
Zeitschrift für Gerontologie + Geriatrie 09/2005; 38(4):288-92. · 0.61 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: Inhalte der Altersmedizin wurden bislang im Medizinstudium in Deutschland nur vereinzelt und fakultativ an Universitten und Medizinischen Hochschulen angeboten. Die reformierte Approbationsordnung enthlt als einen neuen Querschnittsbereich die „Medizin des Alterns und des alten Menschen“ obligatorisch im klinischen Studienabschnitt. Verbindliche Lerninhalte liegen fr diesen Querschnittsbereich jedoch nicht vor. Dieser Bericht beschreibt deshalb ein neu entwickeltes Curriculum mit seinem Schwerpunkt auf Seminaren in kleinen Gruppen, die ersten Erfahrungen sowie die Ergebnisse der Evaluation des Unterrichts durch Studierende an der Universitt Hamburg. Die Ergebnisse belegen eine hohe Akzeptanz von Inhalt und Form des Unterrichts, der von den befragten Studierenden als interessant und lehrreich eingeschtzt wurde.Until very recently, medicine in old age was not an obligatory part of the medical students’ education in Germany. This has been changed by an educational reform. However, there are no obliging recommendations or procedures on which issues of medicine in old age should be taught. Therefore, we describe the development of a new curriculum, first experiences with the teaching, and the results of its evaluation by the students at the University of Hamburg. As a result, the subjects and the didactical teaching were both well accepted by the students and judged as interesting and instructive.
Zeitschrift für Gerontologie + Geriatrie 07/2005; 38(4):288-292. · 0.61 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: The effectivity of a disease management programme (DMP) for outpatients suffering from chronic heart insufficiency (CHI) in primary care is presented. The programme is predominantly based on a weekly telephone monitoring by a case manager using a standardised questionnaire that scores CHI-relevant information of the patient. If the score exceeds a predefined limit the patient's general practitioner is alarmed. An observational study including a total of 115 patients indicates a significant decline of the hospital admission rate (p < 0.0001), as the primary outcome measure, whereas the total length of hospitalization remained constant. The findings are compared with other studies' results and the aims of a randomised controlled trial on the efficacy of DMP on patients with chronic heart failure are discussed.
Das Gesundheitswesen 11/2004; 66(10):656-60. · 0.94 Impact Factor
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ABSTRACT: Objective of this systematic review is to determine the level of scientific evidence for the use of Donepezil in Alzheimer's Disease.
Ten randomised controlled double-blind trials testing Donepezil versus Placebo were identified in MEDLINE and EMBASE. All ten trials were included in this systematic review. Following a detailed catalogue of criteria the methodological standard of the ten trials was assessed.
The authors of eight trials postulated statistically significant differences in favour of Donepezil. Unfortunately, the methodological standard of all studies was insufficient. The methodological shortcomings are discussed in detail.
With regard to severe methodological deficiencies the evidence for the use of Donepezil in moderate to severe Alzheimer's Disease is lacking. But even if the trials had been conducted in a methodologically correct way the clinical relevance of the postulated positive results would have to be questioned.
Fortschritte der Neurologie · Psychiatrie 11/2004; 72(10):557-63. · 0.74 Impact Factor
