Effect of methylphenidate on attention in apathetic AD patients in a randomized, placebo-controlled trial

Krista L. Lanctôt, Sarah A. Chau, Nathan Herrmann, Lea T. Drye, Paul B. Rosenberg, Roberta W. Scherer, Sandra E. Black, Vijay Vaidya, David L. Bachman, Jacobo E. Mintzer

Research output: Contribution to journalArticle

Abstract

Background: Little is known about the effect of methylphenidate (MPH) on attention in Alzheimer's disease (AD). MPH has shown to improve apathy in AD, and both apathy and attention have been related to dopaminergic function. The goal was to investigate MPH effects on attention in AD and assess the relationship between attention and apathy responses. Methods: MPH (10 mg PO twice daily) or placebo was administered for six weeks in a randomized, double-blind trial in mild-to-moderate AD outpatients with apathy (Neuropsychiatric Inventory (NPI) Apathy ≥ 4). Attention was measured with the Wechsler Adult Intelligence Scale - Digit Span (DS) subtest (DS forward, selective attention) and apathy with the Apathy Evaluation Scale (AES). A mixed effects linear regression estimated the difference in change from baseline between treatment groups, defined as δ (MPH (DS week 6-DS baseline)) - (placebo (DS week 6-DS baseline)). Results: In 60 patients (37 females, age = 76 ± 8, Mini-Mental State Examination (MMSE) = 20 ± 5, NPI Apathy = 7 ± 2), the change in DS forward (δ = 0.87 (95% CI: 0.06-1.68), p = 0.03) and DS total (δ = 1.01 (95% CI: 0.09-1.93), p = 0.03) favored MPH over placebo. Of 57 completers, 17 patients had improved apathy (≥3.3 points on the AES from baseline to end point) and 40 did not. There were no significant associations between AES and NPI Apathy with DS change scores in the MPH, placebo, AES responder, or non-responder groups. DS scores did not predict apathy response to MPH treatment. Conclusion: These results suggest MPH can improve attention and apathy in AD; however, the effects appear independent in this population.

Original languageEnglish (US)
Pages (from-to)239-246
Number of pages8
JournalInternational psychogeriatrics
Volume26
Issue number2
DOIs
StatePublished - Feb 1 2014

Keywords

  • Alzheimer's disease
  • Apathy
  • Behavioral and psychological symptoms of dementia (BPSD)
  • Neuropharmacology
  • Psychopharmacology

ASJC Scopus subject areas

  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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  • Cite this

    Lanctôt, K. L., Chau, S. A., Herrmann, N., Drye, L. T., Rosenberg, P. B., Scherer, R. W., Black, S. E., Vaidya, V., Bachman, D. L., & Mintzer, J. E. (2014). Effect of methylphenidate on attention in apathetic AD patients in a randomized, placebo-controlled trial. International psychogeriatrics, 26(2), 239-246. https://doi.org/10.1017/S1041610213001762