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8 patients, worse in 4

no change, 3 had worsened tremor

Abbreviations-. ADAS-cog, Alzheimer's Diseases Assessment scale-cognitive subscale; DLB, dementia with Lewy bodies; MMSE, Mini-Mental State Examination; ND, not described; PDD, Parkinson's disease with dementia; SAPS, Scale for the Assessment of Positive Symptoms; SAS, Simpson-Angus Scale; UPDRS, Unified Parkinson's Disease Rating Scale; VH, visual hallucinations; SPES, Short Parkinson Evaluation Scale.

Abbreviations-. ADAS-cog, Alzheimer's Diseases Assessment scale-cognitive subscale; DLB, dementia with Lewy bodies; MMSE, Mini-Mental State Examination; ND, not described; PDD, Parkinson's disease with dementia; SAPS, Scale for the Assessment of Positive Symptoms; SAS, Simpson-Angus Scale; UPDRS, Unified Parkinson's Disease Rating Scale; VH, visual hallucinations; SPES, Short Parkinson Evaluation Scale.

Scale, NPI-10, MMSE, verbal fluency, Cognitive Drug Research Computerized Assessment System power of attention tests, and the Clock-Drawing test also improved in the rivastigmine group. In a 24-week open extension of this trial (169), patients on rivastigmine in the original trial maintained their improvement at week 48 of treatment, whereas patients who were previously taking placebo and placed on rivastig-mine (mean 7.7mg/day) experienced a 2.8 improvement in ADAS-cog scores at the end of 24 weeks.

In summary, there is emerging data that cholinesterase inhibitors produce a mild-to-moderate benefit on cognition in PD dementia. Although direct comparison between the different drugs is difficult, rivastigmine is the only approved medication for PD dementia. Other possible approaches to improving cholinergic function in the brain, such as dietary supplementation with cholinergic precursors (lecithin) and administration of cholinergic receptor agonists (bethanechol, milameline, tasaclidine), have not been found to be useful in AD and are unlikely to be tried in patients with PD dementia.

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