Systematic Review of Cholinesterase Inhibitors on Cognition and Behavioral Symptoms in Patients of Chinese Descent with Alzheimer’s Disease, Vascular Dementia, or Mixed Dementia

Leung, Kwok‐Yin; Li, Victor C.; Ng, Yuey-Zhun; Chan, Tsz-tai; Chang, Richard S K; Wong, Roger

doi:10.3390/geriatrics2030029

Cited by 7 publications

(6 citation statements)

References 35 publications

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“…Currently, the treatment of AD is focused on controlling the symptoms by reducing the cholinergic deficiency that is characteristic of the disease using AChE inhibitors to compensate the deficiency of acetylcholine (ACh) in the central nervous system (CNS) [ 30 ]. DPZ is widely used in tablet form for oral administration due to its substantial efficacy in improving cognitive functions.…”

Section: Discussionmentioning

confidence: 99%

Formulation Strategies to Improve Nose-to-Brain Delivery of Donepezil

et al. 2019

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Donepezil (DPZ) is widely used in the treatment of Alzheimer’s disease in tablet form for oral administration. The pharmacological efficacy of this drug can be enhanced by the use of intranasal administration because this route makes bypassing the blood–brain barrier (BBB) possible. The aim of this study was to develop a nanoemulsion (NE) as well as a nanoemulsion with a combination of bioadhesion and penetration enhancing properties (PNE) in order to facilitate the transport of DPZ from nose-to-brain. Composition of NE was established using three pseudo-ternary diagrams and PNE was developed by incorporating Pluronic F-127 to the aqueous phase. Parameters such as physical properties, stability, in vitro release profile, and ex vivo permeation were determined for both formulations. The tolerability was evaluated by in vitro and in vivo models. DPZ-NE and DPZ-PNE were transparent, monophasic, homogeneous, and physically stable with droplets of nanometric size and spherical shape. DPZ-NE showed Newtonian behavior whereas a shear thinning (pseudoplastic) behavior was observed for DPZ-PNE. The release profile of both formulations followed a hyperbolic kinetic. The permeation and prediction parameters were significantly higher for DPZ-PNE, suggesting the use of polymers to be an effective strategy to improve the bioadhesion and penetration of the drug through nasal mucosa, which consequently increase its bioavailability.

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Section: Discussionmentioning

confidence: 99%

Formulation Strategies to Improve Nose-to-Brain Delivery of Donepezil

et al. 2019

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“…The effects of medications for controlling behavioral and psychological symptoms of dementia in AD remains controversial. One meta-analysis on the pharmacological management of agitation in dementia supports the use of cholinesterase inhibitors for behavioral and psychological symptoms [ 24 ], but such benefits have not been observed in the Chinese population [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Demographics and Medication Use of Patients with Late-Onset Alzheimer’s Disease in Hong Kong

Wong

Zhong

et al. 2022

JAD

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Background: Alzheimer’s disease (AD) is the most common cause of dementia in the elderly population. However, epidemiological studies on the demographics of AD in Hong Kong population are lacking. Objective: We investigated the demographics, comorbidities, mortality rates, and medication use of patients with AD in Hong Kong to understand how the disease has been managed locally. Methods: This was a collaborative study of The Hong Kong University of Science and Technology and the Hospital Authority Data Collaboration Lab. We analyzed the demographic data, clinical records, diagnoses, and medication records of patients with AD under the care of the Hospital Authority between January 1, 2007 and December 31, 2017. Results: We identified 23,467 patients diagnosed with AD. The median age at diagnosis was 84 years old, and 71% of patients were female. The most common comorbidity was hypertension (52.6%). 39.9% of patients received medications for dementia; of those, 68.4% had taken those medications for > 1 year. Compared to nonusers, long-term AD medication users had a significantly younger age of AD onset and were taking more lipid-regulating medication, diabetes medication, or antidepressants. Surprisingly, the use of antipsychotics in patients with AD was quite common; 50.7% of patients had received any type of antipsychotic during disease progression. Conclusion: This study provides detailed information on the demographics and medication use of patients with AD in Hong Kong. The data from this AD cohort will aid our future research aiming to identify potential AD risk factors and associations between AD and other diseases.

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“…A systematic review of AChEIs for dementia in Chinese participants found heterogeneous results for MMSE. 75 For galantamine, rivastigmine, and memantine, our results were based on single studies and single time points so it is difficult to make comparisons with other meta-analyses. 12,65,69,76 Besides statistical differences, there is the issue of whether the changes were clinically meaningful.…”

Section: Tolerabilitymentioning

confidence: 97%