Olanzapine does not enhance cognition in non-agitated and non-psychotic patients with mild to moderate Alzheimer's dementia

✍ Scribed by John Kennedy; Walter Deberdt; Alan Siegal; Joseph Micca; Elisabeth Degenhardt; Jonna Ahl; Adam Meyers; Christopher Kaiser; Robert W. Baker

• Book ID: 102227154
• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 88 KB
• Volume: 20
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.1397

✦ Synopsis

Objective:

This was an exploratory study of olanzapine as potential treatment for improvement in cognition in patients with alzheimer's disease without prominent psychobehavioral symptoms.

Methods:

Non-psychotic/non-agitated patients (n = 268) with alzheimer's disease, who had baseline mini-mental state examination (mmse) scores of 14-26 were randomized to treatment with olanzapine (2.5 to 7.5 mg/d) or placebo for 26 weeks. the primary objectives were to determine if treatment with olanzapine improved cognition as indexed by the alzheimer's disease assessment scale for cognition (adas-cog) and the clinician's interview-based impression of change (cibic) after 26 weeks of therapy.

Results:

Patients treated with olanzapine vs placebo experienced significant worsening adas-cog scores at weeks 12 (p = 0.03) and 26 (p = 0.004). changes in cibic scores were not significantly different between treatment groups at either assessment. a post hoc analysis revealed that olanzapine-treated patients with more cognitive impairment at baseline (mmse scores of 14-18) (n = 35) experienced significantly greater deterioration in adas-cog performance than patients in the placebo group (n = 24; p < 0.001); whereas in patients with less cognitive impairment (n = 78, baseline mmse scores of 23-26) between-group adas-cog changes were not significant.

Conclusions:

In this 26-week study non-psychotic/non-agitated patients with alzheimer's disease treated with olanzapine experienced significant worsening of cognition as compared to placebo.