Down syndrome and Alzheimer disease Response to donepezil

Background: Individuals with Down syndrome who develop Alzheimer disease may show an improvement in cognitive functioning after treatment with acetylcholinesterase inhibitors. Objective: To determine whether individuals with Down syndrome and Alzheimer disease will show improvement after institution of donepezil treatment. Design: A nonrandomized controlled trial using donepezil in a pilot study format. Setting: Academic medical center. Patients: Convenience sample of 6 treated patients with Down syndrome and 9 closely matched historical control subjects. Intervention: Oral administration of donepezil for a 5-month period. Primary Outcome Measure: The Down Syndrome Dementia Scale. Results: Significant improvement in dementia scores for the treated group during a 3- to 5-month period (P=.03). Conclusions: Acetylcholinesterase inhibitors may be helpful in reversing the symptoms of dementia during early and middle stages of cognitive decline. These findings support the rationale for a more extensive study of the efficacy of acetylcholinesterase inhibitors in Down syndrome dementia.