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Rivastigmine for dementia associated with Parkinson's disease
Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, De Deyn PP, Durif F, Kulisevsky J et al.. The New England journal of medicine, 2004-12-01
Topic: Risk, prevention and care in population studies
Background Cholinergic deficits are prominent in patients who have dementia associated with Parkinson's disease. We investigated the effects of the dual cholinesterase inhibitor rivastigmine in such patients. Methods Patients in whom mild-to-moderate dementia developed at least 2 years after they received a clinical diagnosis of Parkinson's disease were randomly assigned to receive placebo or 3 to 12 mg of rivastigmine per day for 24 weeks. Primary efficacy variables were the scores for the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog) and Alzheimer's Disease Cooperative Study-Clinician's Global Impression of Change (ADCS-CGIC). Secondary clinical outcomes were the scores for the Alzheimer's Disease Cooperative Study-Activities of Daily Living, the 10-item Neuropsychiatric Inventory, the Mini-Mental State Examination, Cognitive Drug Research power of attention tests, the Verbal Fluency test, and the Ten Point Clock-Drawing test. Results A total of 541 patients were enrolled, and 410 completed the study. The outcomes were better among patients treated with rivastigmine than among those who received placebo; however, the differences between these two groups were moderate and similar to those reported in trials of rivastigmine for Alzheimer's disease. Rivastigmine-treated patients had a mean improvement of 2.1 points in the score for the 70-point ADAS-cog, from a baseline score of 23.8, as compared with a 0.7-point worsening in the placebo group, from a baseline score of 24.3 (P Conclusions In this placebo-controlled study, rivastigmine was associated with moderate improvements in dementia associated with Parkinson's disease but also with higher rates of nausea, vomiting, and tremor.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Emre, M., Aarsland, D., Albanese, A., Byrne, E. J., Deuschl, G., De Deyn, P. P., et al. (2004). Rivastigmine for dementia associated with Parkinson's disease. The New England journal of medicine. https://doi.org/10.1056/nejmoa041470
Vancouver
Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, De Deyn PP, et al. Rivastigmine for dementia associated with Parkinson's disease. The New England journal of medicine. 2004. doi:10.1056/nejmoa041470. PMID: 15590953.
BibTeX
@article{emre2004-15590953,
author = {Emre, M. and Aarsland, D. and Albanese, A. and Byrne, E. J. and Deuschl, G. and De Deyn, P. P. and Durif, F. and Kulisevsky, J. and others},
title = {{Rivastigmine for dementia associated with Parkinson's disease}},
journal = {The New England journal of medicine},
year = {2004},
doi = {10.1056/nejmoa041470},
pmid = {15590953},
url = {https://doi.org/10.1056/nejmoa041470}
}
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Key findings
- Background Cholinergic deficits are prominent in patients who have dementia associated with Parkinson's disease.
- Results A total of 541 patients were enrolled, and 410 completed the study.
- Rivastigmine-treated patients had a mean improvement of 2.1 points in the score for the 70-point ADAS-cog, from a baseline score of 23.8, as compared with a 0.7-point worsening in the placebo group, from a baseline score of 24.3 (P<0.001).
Why it matters
In this 24-week trial, 541 people with Parkinson's disease who developed mild-to-moderate dementia at least 2 years after diagnosis (not Alzheimer's disease) were randomly assigned to rivastigmine or placebo, and 410 completed it. On the 70-point ADAS-cog thinking scale, the rivastigmine group improved by 2.1 points on average while the placebo group worsened by 0.7. The authors call the benefit "moderate" and similar to rivastigmine trials in Alzheimer's disease, and they report "higher rates of nausea, vomiting, and tremor".
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Study details
- Participants541
- Evidence strengthLow
How this study scored 78/100
Published in a top-tier journal, and it is a randomized controlled trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (The New England journal of medicine) |
| Journal's citation record | 4 / 4 | New England Journal of Medicine: journal h-index 1,505 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomized controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2004 — older than 20 years, still counted |
| Sample size | 2 / 4 | 541 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) |
| Randomized / blinded | 2 / 2 | Randomized and blinded or placebo-controlled (as stated in the record) |
| Times cited | 7 / 7 | Cited 1,225 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 51.0 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 6 / 6 | Cited 50.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 45 other studies in this library |
| Still being cited | 3 / 4 | Cited 99 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Roger M. Lane: h-index 47 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multicenter collaboration | 3 / 3 | OpenAlex lists 18 institution(s) in 14 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15590953) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 78 / 100 | — |
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Read the original
- DOI: 10.1056/nejmoa041470
- PubMed: 15590953
- Original source →
- Free full text: New England Journal of Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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