Hallucinations predict attentional improvements with rivastigmine in dementia with lewy bodies

The aim of this analysis of the effects of cholinergic therapy in dementia with Lewy bodies was to determine whether rivastigmine-induced benefits in attention and memory could be predicted by the presence of visual hallucinations. At study entry, 74% of patients were hallucinators and 26% were non-hallucinators. The population was analyzed for two-factor scores: power of attention (PoA) and quality of memory (QoM). A significant effect over placebo on PoA was observed in hallucinators at weeks 12 (p = 0.023) and 20 (p = 0.0019), while no treatment effects were seen in non-hallucinators. Significant treatment effects on QoM were not observed in either subgroup. Visual hallucinations predicted greater improvements in PoA, but not QoM. This may reflect the greater cholinergic deficits in areas of the brain responsible for visual hallucinations, offering greater potential for attentional improvement.