A Cochrane review [Abstract] 1 included two studies with a total of 1 219 subjects with mild to moderate cognitive decline due to probable or possible vascular dementia. Donepezil, at doses of 5 or 10 mg a day was compared with placebo for 24 weeks. The withdrawal rate was low and due mainly to side effects.
The donepezil groups showed statistically significantly better performance than the placebo groups on the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog) and on the Mini-Mental State Examination (MMSE) at 12 and 24 weeks. In global function, the Clinical Dementia Rating (CDR-SB) showed at 24 weeks a statistically significant benefit of 10 mg donepezil daily over both placebo and a 5 mg daily dosage. The Clinician's Interview-Based Impression of Change-plus version (CIBIC-plus) showed improved global function of participants taking 5 mg of donepezil daily compared with the placebo group but this was not seen in the higher dose group. On the Instrumental Activity of Daily Living (IADL) scale, there was no statistically significant difference between the groups taking donepezil 5mg per day donepezil and placebo, but the group taking 10 mg of donepezil a day showed benefit compared with placebo. There were statistically significant benefit for donepezil at either dosage compared with placebo on the Alzheimer's Disease Functional Assessment and Change Scale (ADFACS).
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