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. Author manuscript; available in PMC: 2013 Nov 1.
Published in final edited form as: J Am Geriatr Soc. 2012 Oct 30;60(11):2127–2136. doi: 10.1111/j.1532-5415.2012.04209.x

Table 2.

Cognitive Pharmacotherapy for Balance, Gait and Fall Risk

Study (years) Study design Type of intervention Duration of intervention Participants Summary of findings
Auriel et al. (2006) Open-label, before–after design Before and 2 h after taking a single dose of 20 mg of MPH 2 h 21 patients with idiopathic PD who receive l-Dopa, (mean age: 70.2 ± 9.2 years, MMSE: 28.8 ± 1.7) Improvement in the Attention (p = 0.025), whereas the EF Index showed only a trend (p = 0.099). The Timed Up and Go (p = 0.001), gait velocity (p = 0.005) and stride time variability (p = 0.013) showed significant improvements
Ben-Itzhak et al. (2008) RCT, double- blind, placebo-controlled Before and 2 h after taking 20 mg MPH or a placebo 2 h 26 older adults without dementia with subjective memory complaints (mean age: 73.8 ± 1.2 years, mean MMSE: 27.8 ± 1.4) MPH improved Timed Up and Go (p = 0.004), stride time variability (p = 0.03) and EF (p = 0.03); effects not observed after treatment with the placebo
Montero-Odasso et al. (2009) Open-label study with controls 5 mg/day of donepezil for 1 month, and another 3 months with 10 mg/day. The MCI group with no treatment Up to 4 months Six patients with mild AD (mean age: 79.9 ± 4.8 years; MMSE: 22.3 ± 1.2; MoCA: 15 ± 1.4) compared with eight patients with MCI (mean age: 75.6 ± 6.2 years; MMSE: 27.9 ± 1.7; MoCA: 22.9 ± 1.7) AD patients increased their gait velocity after 1 month under single (p = 0.045) and dual-tasking (p = 0.047). Stride time variability decreased (improved) during follow-up. These increases were maintained for 4 months. Gait measures in the MCI (control) group were worse than at baseline
Assal et al. (2008) Before–after design Galantamine mean dose of 17.8 ± 3.5 mg/day 24 weeks Nine patients with mild- to-moderate AD (mean age: 77.9 ± 2.1 years; mean MMSE: 26.4 ± 5.2) compared with 18 no-treatment control subjects without dementia (mean age: 78.1 ± 1.0 years; mean MMSE: 29.4 ± 0.8) Stride time was shorter under dual-tasking after treatment (p = 0.01). There was no change in the controls
Chung et al. (2010) Randomized, crossover, double-blind Donepezil compared with placebo. In each drug phase, subjects were instructed to take 5 mg/day of donepezil or placebo for 3 weeks and to increase to 10 mg/day for the remaining 3 weeks 6 weeks, 3 weeks washout, 6 weeks of placebo 23 patients with PD who reported falling or nearly falling (mean age: 68.3 ± 10.8 years; MMSE: 27.6 ± 4.5) Less falls with donepezil than when taking placebo (p = 0.049). Subjects with the most falls at baseline tended to show the largest improvements. No differences in Activities of Balance Confidence Scale, Berg Balance Scale, UPDRS III or MMSE scores
Beauchet et al. (2011) Before–after design Memantine mean dose of 20 mg/day in the morning - titrated in 5 mg increments over 4 weeks 211.0±78.2 days 17 patients with AD (mean age 83.8±5.8 years; 52.9% women; MMSE at baseline: 14.5±4.2) and 32 age- and gender-matched control patients with AD without any anti-dementia drug (mean age 80.0±6.6 years; 56.3% women; MMSE at baseline: 23.2±5.3) Stride time variability decreased (improved) during follow-up in the memantine group (6.3±6.1 versus 3.6±1.3, P=0.038)

Note: AD: Alzheimer’s disease; EF: Executive function; MCI: Mild cognitive impairment; MMSE: Mini Mental State Examination; MoCA: Montreal Cognitive Assessment; MPH: Methylphenidate; PD: Parkinson’s disease; UPDRS: Unified Parkinson’s Disease Rating Scale. Adapted with permission from Segev-Jacubovski et al [56].