EFFECT OF TACRINE ON LANGUAGE, PRAXIS, AND NONCOGNITIVE BEHAVIORAL-PROBLEMS IN ALZHEIMER-DISEASE

Objective: To examine the effects of tacrine hydrochloride in patients with Alzheimer disease (AD) and detectable baseline deficits in discr ete cognitive and noncognitive parameters who were enrolled in a previ ously reported multicenter, double-blind, 30-week trial. Design: An ex ploratory analysis using last observation carried forward. The study p opulation included a placebo group (n=181) and all patients randomized to treatment with 160 mg/d of tacrine hydrochloride (n=238), regardle ss of highest dose achieved or duration of tacrine therapy. Study Popu lation: Male and female subjects, at least 50 years of age, with mild to moderate AD and detectable baseline deficits in discrete cognitive and noncognitive parameters. Main Outcome Measures: Change from baseli ne to last observation carried forward in discrete subscale scores of the Alzheimer's Disease Assessment Scale (ADAS): cognitive (memory, la nguage, praxis) and noncognitive (mood, behavior). Improvement was def ined as a decrease of at least 1 point hom baseline; stabilization was defined as no change or a decrease from baseline. Results: Compared w ith the placebo group, the percentage of patients receiving tacrine wh ose conditions improved or stabilized was significantly greater for 8 of 11 ADAS-cognitive items (word recall, word recognition, orientation , language production, comprehension, word finding, following commands , ideational praxis) and for the ADAS-noncognitive items: cooperation, delusions, and pacing. Conclusions: Tacrine stabilizes or improves sp ecific behavioral deficits and symptoms in AD. The previous demonstrat ion of tacrine's effect on global cognitive function has been extended by suggesting an association between tacrine therapy and improvements in individual cognitive and noncognitive items of the ADAS. Effects o f tacrine in clinical practice might be more accurately and efficientl y assessed by measuring individual ADAS cognitive and noncognitive ite ms relevant to individual patient pretreatment clinical status.