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Donepezil is associated with delayed nursing home placement in patients with Alzheimer's disease
Geldmacher DS, Provenzano G, McRae T, Mastey V, Ieni JR.. Journal of the American Geriatrics Society, 2003-07-01
Topic: Amyloid, tau and blood-test diagnosis
Objectives To assess the relationship between donepezil treatment and time to nursing home placement (NHP) for patients with Alzheimer's disease (AD). Design Observational follow-up of patient NHP and vital status. Setting Community. Participants Patients previously enrolled in one of three randomized, double-blind, placebo-controlled clinical trials of donepezil and two subsequent open-label studies (total N = 1,115); 671 patients provided complete data for analysis. Measurements Data were obtained through follow-up interviews with caregivers and chart reviews of patients with AD. Comparison groups were defined by whether patients received an effective dose of donepezil (>/=5 mg/d; >/=80% compliance) for specific numbers of weeks during the double-blind or open-label trial phase, in both phases, or in neither. Cox proportional hazards models were used to estimate risk ratios for NHP and survival curves from which median times to NHP were estimated for first dementia-related placement of longer than 2 weeks and permanent placement. The models were adjusted for age, sex, baseline Mini-Mental State Examination score, whether the caregiver was a spouse, caregiver continuity, and use of other cholinesterase inhibitors after the clinical trials. Results Use of donepezil of 5 mg/d or more was associated with significant delays in NHP. A cumulative dose-response relationship was observed between longer-term sustained donepezil use and delay of NHP. When donepezil was taken at an effective dose for at least 9 to 12 months, conservative estimates of the time gained before NHP were 21.4 months for first dementia-related NHP and 17.5 months for permanent NHP. Conclusion Use of donepezil by AD patients resulted in significant delays in NHP. Long-term use of donepezil may help AD patients live longer in community settings, with consequent personal, social, and economic benefits.
Key findings
- Results Use of donepezil of 5 mg/d or more was associated with significant delays in NHP.
- Conclusion Use of donepezil by AD patients resulted in significant delays in NHP.
Why it matters
In this follow-up of patients from earlier trials, taking donepezil at 5 mg per day or more was associated with significant delays in nursing home placement. This concerns a symptomatic treatment effect on placement timing and does not show that donepezil cures or prevents Alzheimer's disease.
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Study details
- Study designopen-label trial
- Participants1,115
- Evidence strengthHigh
How this study scored 70/100
Published in a peer-reviewed journal, and it is a large phase 3 trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A large phase 3 trial (from PubMed type “Clinical Trial, Phase III”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 3 / 4 | 1,115 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 6 / 7 | Cited 314 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.6 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 5 / 6 | Cited 22.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 13 other studies in this library |
| Still being cited | 1 / 4 | Cited 10 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author John R. Ieni: h-index 23 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Case Western Reserve University: institution h-index 1,159 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12834513) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 70 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Geldmacher, D. S., Provenzano, G., McRae, T., Mastey, V., & Ieni, JR. (2003). Donepezil is associated with delayed nursing home placement in patients with Alzheimer's disease. Journal of the American Geriatrics Society. https://doi.org/10.1046/j.1365-2389.2003.51306.x
Vancouver
Geldmacher DS, Provenzano G, McRae T, Mastey V, Ieni JR. Donepezil is associated with delayed nursing home placement in patients with Alzheimer's disease. Journal of the American Geriatrics Society. 2003. doi:10.1046/j.1365-2389.2003.51306.x. PMID: 12834513.
BibTeX
@article{geldmacher2003-12834513,
author = {Geldmacher, D. S. and Provenzano, G. and McRae, T. and Mastey, V. and Ieni, JR.},
title = {{Donepezil is associated with delayed nursing home placement in patients with Alzheimer's disease}},
journal = {Journal of the American Geriatrics Society},
year = {2003},
doi = {10.1046/j.1365-2389.2003.51306.x},
pmid = {12834513},
url = {https://doi.org/10.1046/j.1365-2389.2003.51306.x}
}
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