Objective: We explored the use of Rivastigmine in Parkinson’s and Lewy body dementia through assessment of quantitative data obtained from a clinical database. We focussed on tolerability, duration of usage and standard of documentation.

Background: People with Parkinson’s (PwP) have  a six-fold increased likelihood of developing dementia when compared to healthy age-matched controls (Aarsland et al. 2001). Increased cerebral deposition of alpha synuclein has been associated with dementia with Parkinson’s (Kurtz and Kaufer 2011). Rivastigmine is the first-line treatment recommended in the UK

Methods: We audited the use of Rivastigmine via our clinical database in a University hospital Parkinson’s clinic in South Wales. We assessed 163 patients for parameters including age, gender, diagnoses, date of diagnoses, initiation date of Rivastigmine, drug dose, date of termination of Rivastigmine (where applicable), adverse effects reported and present residence.

Results: Of the 163 patients evaluated,109 were male. Adverse effects to Rivastigmine were reported in 5.5% of patients, however the exact nature of these adverse effects was not described. At the time of audit, most patients (60.1%) were resident in their own homes. 52.1% were found to have unknown initiation dates for Rivastigmine. The average duration of use was 37.9 months

Conclusions: The retrospective nature of this review precluded further exploration of data due to incomplete documentation and is an area to focus on. There appears to be a significant proportion of people with dementia on Rivastigmine who are still resident in their own home and not reliant on institutional care. The authors conclude that AChEI may be contributing to delaying institutionalisation by positively impacting on behavioural and psychological problems associated with dementia. This aspect needs to be explored further. Rivastigmine appears to be well tolerated in this frail cohort.

References: Aarsland, D., Andersen, K., Larsen, J. P., Lolk, A., Nielsen, H. and Kragh-Sorensen, P. (2001). Risk of dementia in Parkinson’s disease: a community-based prospective study. Neurology 56:730-736.

Kurtz, A. L. and Kaufer, D. I. (2011). Dementia in Parkinson’s disease. Curr treat options neurol 13:242-254.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/do-acetylcholinesterase-inhibitors-achei-delay-institutionalisation-in-parkinsons-and-lewy-body-disease/