Table I.
Summary of studies included in the present meta-analysis.
| First author (year) | Total (n) | Condition | Duration/design | Drug | Age (mean ± SD) | Males (%) | n of each group | Dose (mg/day) | Outcomes | (Refs.) |
|---|---|---|---|---|---|---|---|---|---|---|
| Aarsland (2002) | 14 | CIND-PD | 10 weeks | DON | 71±3.9 | 92 | 12 | 10 (flexible dose) | MMSE, CIBIC-plus, | (24) |
| (crossover design) | UPDRS-motor, NPI | |||||||||
| Ravina (2005) | 22 | PDD | 10 weeks | DON | DON/PLA: 75.0±9.8 | DON/PLA: 100 | 19 | 10 (flexible dose) | MMSE, CGI-CADAS-cog, | (27) |
| (crossover design) | PLA | PLA/DON: 72.1±8.1 | PLA/DON: 60 | 19 | MDRS, BPRS, UPDRS-motor | |||||
| Mori (2012) | 140 | DLB | 12 weeks | DON 10 mg | DON 10 mg: 78.6±6.1 | DON 10 mg: 11.1 | 37 | 10 (flexible dose) | MMSE, WMS-R, WAIS-III, | (23) |
| DON 5 mg | DON 5 mg: 77.9±6.8 | DON 5 mg: 50.0 | 33 | 5 (flexible dose) | NPI, VF, VPTA, UPDRS-motor | |||||
| DON 3 mg | DON 3 mg: 79.6±4.5 | DON 3 mg: 48.6 | 35 | 3 (flexible dose) | ||||||
| PLA | PLA: 78.6±4.7 | PLA: 28.1 | 35 | PLA | ||||||
| Ikeda (2015) | 142 | DLB | 12 weeks | DON 10 mg | DON 10 mg: 77.7±6.8 | DON 10 mg: 42.9 | 49 | 10 (fixed dose) | MMSE, NPI, UPDRS-motor | (22) |
| DON 5 mg | DON 5 mg: 78.8±5.1 | DON 5 mg: 44.4 | 47 | 5 (fixed dose) | ||||||
| PLA | PLA: 77.2±6.1 | PLA: 38.6 | 46 | |||||||
| Dubois (2012) | 550 | PDD | 24 weeks | DON 10 mg | DON 10 mg: 70.8±7.46 | DON 10 mg: 75 | 182 | 10 (fixed dose) | CIBIC-plus, MMSE, VF, BTA, | (25) |
| DON 5 mg | DON 5 mg: 72.0±6.83 | DON 5 mg: 65 | 195 | 5 (fixed dose) | ADAS-cog, NPI | |||||
| PLA | PLA: 72.9±6.48 | PLA: 65 | 173 | PLA | ||||||
| McKeith (2000) | 120 | DLB | 20 weeks | RIV | RIV: 73.9±6.5 | RIV: 52.5 | 59 | 12 (flexible dose) | NPI, CGC-plus, MMSE | (28) |
| PLA | PLA: 73.9±6.4 | PLA: 60.7 | 61 | |||||||
| Emre (2010) | 199 | DLB and PDD | 24 weeks | MEM | MEM: 74.4±5.8 | MEM: 53.1 | 96 | MEM: 20 (fixed dose) | ADCS-CGIC, NPI, UPDRS | (34) |
| PLA | PLA: 72.5±7.0 | PLA: 57.6 | 99 | |||||||
| Leroi (2009) | 25 | PDD | 16 weeks (from | MEM | MEM: 76.7±7.8 | MEM: 36.4 | 11 | MEM: 20 (fixed) | MMSE, NPI, UPDRS-3, CIBIC-Plus | (32) |
| 17 weeks to 22 weeks: Off drug) | PLA | PLA: 74.7±7.9 | PLA: 4.3 | 14 | ||||||
| Leroi (2004) | 16 | PDD or | 18 weeks | DON | DON: 66.2±9.3 | DON: 85.7 | 7 | 10 mg (flexible dose) | Cognitive domains, VMI, NPI, | (26) |
| CIND-PD | PLA | PLA: 70.8±11.8 | PLA: 44.4 | 9 | UPDRS-ADL, Motor function, Complication of treatment | |||||
| Emre (2004) | 541 | PDD | 24 weeks | RIV | RIV: 72.8±6.7 | RIV: 64.6 | 362 | 12 mg (flexible dose) | ADAS-cog, ADCS-CGIC, NPI-10, | (29) |
| PLA | PLA: 72.4±6.4 | PLA: 65.4 | 179 | MMSE, VF, CDT, UPDRS-motor | ||||||
| Mamikonyan (2015) | 28 | CIND-PD | 10 weeks | RIV patch | 64.3±8.2 | 78.6 | 27 | 9.5 mg (flexible dose) | ADCS-CGIC, MoCA, PDRS-motor | (30) |
| (crossover design) | PLA | 27 | ||||||||
| Wesnes (2002) | 92 | DLB | 20 weeks | RIV | RIV: 73.9±6.5 | RIV: 52.5 | 41 | 12 mg (flexible dose) | DSST, attention, processing speed, | (31) |
| (crossover design) | PLA | PLA: 73.9±6.4 | PLA: 60.7 | 51 | Stroop Congruent Test, Trails A/B, Word Association Test | |||||
| Li (2015) | 81 | PD-MCI, PDD | 12 months | RIV | RIV: 67.5±not clear | RIV: 73.2 | 41 | 3 mg (flexible dose) | MoCA, falls | (10) |
| PLA clear | PLA: 66.9±not | PLA: 52.5 | 40 | |||||||
| Aarsland (2009) | 72 | PDD, DLB | 24 weeks (from 17 weeks to 22 weeks: Off drug) | MEM | MEM: 76.9±6.1 | MEM: 79.4 | 34 | 20 mg (flexible dose) | CGIC, MMSE, NPI, UPDRS | (33) |
| PLA | PLA: 76.2±5.8 | PLA: 71.1 | 38 | |||||||
| Stubendorff (2014) | 75 | PDD; DLB | 24 weeks | MEM | MEM: 73.8±5.5a, 75.2±5.6b | MEM: 75a, 100b | 18 (12/6) | 20 mg (flexible dose) | Survival | (35) |
| PLA | PLA: 76.5±4.7a, 75.6±4.6b | PLA: 66.7a, 60b | 14 (9/5) |
Subgroup 1
subgroup 2. PDD, Parkinson's disease with dementia; DLB, dementia with Lewy bodies; MCI, mild cognitive impairment; PLA, placebo; MEM, memantine; RIV, rivastigmine; CIND-PD, cognitive impairment in Parkinson's disease; DON, donepezil; MMSE, Mini Mental State Examination; MoCa, Montreal Cognitive Assessment; CIBIC, Clinician's Interview-Based Impression of Change; UPDRS, Unified Parkinson's Disease Rating Scale; NPI, Neuropsychiatric Inventory; CGI-CDRCAS, Clinical Global Impression-Cognitive Drug Research Computerized Assessment System; BPRS, Brief Psychosis Rating Scale; MDRS, Mattis Dementia Rating Scale; VF, Verbal Fluency; VMI, develop-mental test of Visual-Motor Integration; VPTA, Visual Perception Test for Agnosia; WAIS-III Wechsler Adult IntelligenceScale; WMS-R, Wechsler Memory Scale-Revised; CDT, clock drawing test; CGC-plus, Clinical Global Change-plus; ADL, Activities of Daily Living; ADCS-CGIC, Alzheimer's Disease Cooperative Study-Clinician's Global Impression of Change; ADAS-cog, Alzheimer's Disease Assessment Scale cognitive subscale; SD, standard deviation; DSST, Digit Symbol Substitution Test; BTA, Brief test of Attention.