Aims: The aim of this study was to assess, in a natural setting, the development of cognitive, behavioral and functional performance of elderly dementia patients treated with cholinesterase inhibitors (ChEIs) during a 21-month follow-up. Another aim was to compare patterns of clinical changes in relation to patients' level of cognitive impairment at the beginning of therapy.
Method: Of the 1987 elderly demented patients seen at our unit, 143 met the inclusion/ exclusion criteria, were followed for at least 21 months, and were thus included in the study. At baseline and each control point (up to 21 months), patients were scored for Mini Mental State Examination (MMSE), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL).
Results: After 21 months' treatment with ChEIs, patients showed a significant reduction in MMSE, ADL and IADL values. The MMSE score decreased by 1.7 points/year (95% CI -2.1; -1.3), irrespective of initial cognitive level, and was lower than that expected in non-treated patients (-3/-4 points/year).
Conclusion: ChEI therapy is effective in slowing the progression of dementia, even in the long term, irrespective of baseline cognitive level.