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Top cited papers in international psychogeriatrics: 1. Long-term use of rivastigmine in patients with Dementia with Lewy bodies: An open-label trial

Lookup NU author(s): Professor Ian McKeith



Eleven authors, 29 patients and an open-label design would not generally be regarded as strong predictors of a publication's citation success, so this one (Grace et al., 2001) probably needs some explaining. I was advised early in my prospective publishing career always to look for a gap in the market and in 2001 this short paper probably filled a significant gap in clinical knowledge. It was almost a decade since the first reports had appeared about dementia with Lewy bodies (DLB) being a relatively common cause of dementia in older people, and by 2001 the first iteration of the consensus criteria for DLB diagnosis was starting to be widely used. Clinicians were therefore becoming more confident about recognizing DLB in their clinics, realized that cholinesterase inhibitors (ChEIs) were often useful in symptom control, and wanted to know more about their effects in the longer term. This short paper gave them some useful evidence to support their practice. The lead author, Janet Grace, who was working as my clinical lecturer, had for a couple of years been following up a group of DLB patients whom she had originally entered in an earlier placebo controlled study (McKeith et al., 2000) and was interested in charting their progress with the ready help of U.K. colleagues in Essex, Manchester, Southampton and Nottingham. Although the 21 patients who remained on treatment did show some evidence of disease progression after two years, neither their Mini-mental State Examination (MMSE) scores nor their Neuropsychiatric Inventory (NPI) scores were significantly worse than at baseline. And reassuringly their parkinsonism had not worsened, which was a common concern at that time. © 2009 International Psychogeriatric Association.

Publication metadata

Author(s): McKeith I

Publication type: Review

Publication status: Published

Journal: International Psychogeriatrics

Year: 2009

Volume: 21

Issue: 1

Pages: 5-6

ISSN (print): 1041-6102

ISSN (electronic): 1741-203X


DOI: 10.1017/S1041610208008168

PubMed id: 19144212