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Donepezil in the Prevention of Post-Operative Cognitive Decline

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ClinicalTrials.gov Identifier: NCT00182845
Recruitment Status : Completed
First Posted : September 16, 2005
Last Update Posted : March 3, 2008
Information provided by:
National Institute on Aging (NIA)

Brief Summary:
The purpose of this study is to evaluate the feasibility of using Donepezil to prevent post-operative cognitive decline (POCD) among individuals aged 65 and older who have a baseline mild cognitive impairment (MCI) and are undergoing elective hip or knee replacement.

Condition or disease Intervention/treatment Phase
Postoperative Complications Delirium Drug: Donepezil Phase 4

Detailed Description:

Up to 65% of elderly patients undergoing hip or knee surgery suffer from declining brain function known as post-operative cognitive decline (POCD). These individuals often stay in the hospital longer, have more complications, and are more likely to die. Recent clinical studies have shown the potential benefit of enhancing the cholinergic system among patients with both Alzheimer's disease and / or vascular dementia. Donepezil is currently being used to treat memory loss in patients with Alzheimer's disease.

This study will recruit 30 cognitively impaired adults aged 65 or older who are scheduled to have elective hip or knee replacement surgery at University Hospital. Participants will be randomized to receive either a three to six week supply of Donepezil or a matching placebo approximately 4 weeks prior to surgery. This study will evaluate the effect of Donepezil on delirium incidence and severity during hospitalization, global cognitive function, length of hospitalization, site of discharge, and adverse drug effects.

All material to be collected will be from interviews, questionnaires, and medical chart review. Some will be at baseline, during hospitalization, and 12 weeks post hospitalization and others will be daily during hospitalization. The International Study of Post-Operative Cognitive Decline battery of tests will be used in assessment, as will the CogHealth computerized battery.

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Study Type : Interventional  (Clinical Trial)
Enrollment : 30 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Prevention
Official Title: Preventing Post-Operative Cognitive Decline
Study Start Date : February 2005
Actual Primary Completion Date : April 2007
Actual Study Completion Date : April 2007

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Changes in the International Study of Post-Operative Cognitive Decline (ISPOCD) and the CogHealth computerized battery tests at 1 week and 12 weeks after surgery

Secondary Outcome Measures :
  1. Delirium status measured by the Confusion Assessment Method (CAM) and the Memorial Delirium Assessment Scale (MDAS) daily during the post-operative period
  2. Global cognitive status assessed using the Mini Mental Status Exam (MMSE)
  3. Length of stay in the hospital post-operatively
  4. Discharge site
  5. Adverse effects

Information from the National Library of Medicine

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Ages Eligible for Study:   65 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Community-dwelling individuals aged 65 or older
  • Scheduled for elective hip or knee replacement at University Hospital
  • Mild cognitive impairment, defined as:

    • MMSE total score of 27 or less;
    • normal performance of the activities of daily living tasks of the Bristol scale after excluding mobility related difficulties;
    • no chart-based dementia diagnosis; and
    • no history of ever being on dementia medications such as Memantine or any cholinesterase inhibitors
  • Consent to participate in the study

Exclusion Criteria:

  • Chart-based dementia diagnosis
  • MMSE score greater than 27
  • Difficulty performing the activities of daily living not related to mobility as measured by the Bristol scale
  • Current or past history of receiving dementia medications such as Memantine or any cholinesterase inhibitors (Tacrine, Donepezil, Rivastigmine, or Galantamine)
  • Metastatic cancer or other comorbid illnesses likely to reduce life expectancy to under 6 months
  • Multiple trauma or pathological fractures requiring acute hip or knee replacement
  • Aphasic, blind, or deaf
  • Use of neuroleptics one month prior to surgery
  • Allergy to donepezil
  • Inability to read and complete study tests and forms
  • Alcohol or drug dependence, defined as intake of more than 5 units of alcohol daily during the past 3 months
  • Not expected to be discharged from hospital or able to complete the 3-month postoperative test
  • Not competent to make medical decisions

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00182845

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United States, Indiana
University Hospital, Clarian Health Partners
Indianapolis, Indiana, United States, 46202
Sponsors and Collaborators
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Principal Investigator: Malaz Boustani, MD, MPH Regenstrief Institute, Indiana University Center for Aging Research
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ClinicalTrials.gov Identifier: NCT00182845    
Other Study ID Numbers: IA0078
First Posted: September 16, 2005    Key Record Dates
Last Update Posted: March 3, 2008
Last Verified: February 2008
Keywords provided by National Institute on Aging (NIA):
Adverse Effects
Hospital Acquired Complications
Cognitive Impairment
Additional relevant MeSH terms:
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Postoperative Complications
Cognitive Dysfunction
Neurocognitive Disorders
Mental Disorders
Pathologic Processes
Cognition Disorders
Cholinesterase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Cholinergic Agents
Neurotransmitter Agents
Physiological Effects of Drugs
Nootropic Agents