Metrifonate Enhances the Ability of Alzheimer's Disease Patients to Initiate, Organize, and Execute Instrumental and Basic Activities of Daily Living

The objective of this analysis was to evaluate comprehensively the efficacy of metrifonate, a long-acting acetylcholinesterase inhibitor, in improving the ability of mild-to-moderate Alzheimer's disease (AD) patients to perform activities of daily living (ADLs). Alzheimer's disease patient...

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Bibliographic Details
Published in:Journal of geriatric psychiatry and neurology 2000-04, Vol.13 (1), p.9-16
Main Authors: Gélinas, Isabelle, Gauthier, Serge, Cyrus, PamelaA
Format: Article
Language:English
Subjects:
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Alzheimer Disease - diagnosis
Alzheimer Disease - drug therapy
Alzheimer Disease - psychology
Biological and medical sciences
Cholinesterase Inhibitors - administration & dosage
Cholinesterase Inhibitors - adverse effects
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Double-Blind Method
Female
Humans
Male
Medical sciences
Mental Status Schedule
Neurology
Neuropharmacology
Pharmacology. Drug treatments
Prospective Studies
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Treatment Outcome
Trichlorfon - administration & dosage
Trichlorfon - adverse effects
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Summary:The objective of this analysis was to evaluate comprehensively the efficacy of metrifonate, a long-acting acetylcholinesterase inhibitor, in improving the ability of mild-to-moderate Alzheimer's disease (AD) patients to perform activities of daily living (ADLs). Alzheimer's disease patients with Mini-Mental State Examination scores of 10 to 26 were enrolled in three 26-week trials to receive once-daily placebo (n = 430) or metrifonate 30 to 60 mg (by weight, n = 650) or 60/80 mg (by weight, n = 197). Metrifonate efficacy was assessed using the Disability Assessment for Dementia scale. Data from the three studies were pooled and analyzed retrospectively. The intent-to-treat analysis (last observation carried forward) at 26 weeks demonstrated that metrifonate significantly improved the ability of AD patients to perform ADLs when compared with placebo (30-60 mg dose, Δ = 3.03; P = .002; 60/80 mg dose, Δ = 5.25; P = .0002). Metrifonate significantly improved the ability of the AD patients to perform instrumental ADLs, those abilities typically lost first during the disease process (30-60 mg dose, Δ = 3.88, P = .002; 60/80 mg dose, Δ = 5.79, P = .003). Metrifonate also tended to improve, relative to placebo, the ability of AD patients to use three levels of executive skills when performing ADLs: initiation (30-60 mg dose, Δ = 3.45, P = .001; 60/80 mg dose, Δ = 5.44, P = .003), planning/organization (30-60 mg dose, Δ = 4.50, P = .004; 60/80 mg dose, Δ = 4.89, P = .014), and effective execution (30-60 mg dose, Δ = 1.80, P = .076; 60/80 mg dose, Δ = 4.06, P = .030). These results indicate that metrifonate has a beneficial effect on the ADLs in mild-to-moderate AD patients. ( J Geriatr Psychiatry Neurol 2000; 13:9-16).
ISSN:0891-9887
1552-5708
DOI:10.1177/089198870001300102