Objective: To evaluate the efficacy of rivastigmine in patients with Parkinson’s disease (PD) by assessing its impact on motor symptoms, cognitive function, gait, falls, and quality of life through a systematic review and meta-analysis of PubMed database.
Background: Rivastigmine, a cholinesterase inhibitor, is commonly used for cognitive symptoms in PD. Its effects on motor function, gait, falls, and quality of life remain unclear. This meta-analysis consolidates data from double-blind, placebo-controlled randomized controlled trials (RCTs) to assess rivastigmine’s overall impact on PD.
Method: A systematic search of PubMed was performed following PRISMA guidelines to identify double-blind, placebo-controlled RCTs evaluating rivastigmine in PD. Four studies (PMID: 15590953, 24218528, 26288230, 26795874) were included. Key outcomes assessed included UPDRS-Total, UPDRS-III (motor score), gait speed, fall numbers, PDQ-39 (quality of life), MDRS (depression scale), MADRS (depression scale), MOCA (cognitive score), and MMSE (Mini-Mental State Examination). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated.
Results: Rivastigmine demonstrated modest improvements in motor symptoms, with a standardized mean difference (SMD) of 0.27 (95% CI: 0.08, 0.45) for UPDRS-Total, indicating small but significant motor function enhancement. Gait speed also improved significantly, with a mean difference of 3.7 meters per second (95% CI: 2.98, 4.46). Regarding fall reduction, rivastigmine was associated with a mean difference of -0.49 (95% CI: -0.93, -0.05), suggesting a beneficial effect in reducing falls. Cognitive outcomes, particularly on the Montreal Cognitive Assessment (MOCA), showed a large effect (SMD: 1.64, 95% CI: 1.13, 2.15). Depressive symptoms (MDRS and MADRS) showed mixed results, with no significant improvements reported across the studies.
Conclusion: Rivastigmine has a modest positive effect on motor function, gait, and cognition in PD patients, with some evidence of reducing fall frequency. The treatment shows promise in improving cognitive symptoms, though its impact on depressive symptoms and overall motor scores remains less clear.
To cite this abstract in AMA style:
V. Byroju, J. Pitton Rissardo, A. Fornari Caprara. The Effectiveness of Rivastigmine in Parkinson’s Disease: Impact on Motor Symptoms, Gait, Cognitive Function, and Falls – A Systematic Review and Meta-Analysis of Double-Blind, Placebo-Controlled RCTs [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/the-effectiveness-of-rivastigmine-in-parkinsons-disease-impact-on-motor-symptoms-gait-cognitive-function-and-falls-a-systematic-review-and-meta-analysis-of-double-blind-placebo-contro/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effectiveness-of-rivastigmine-in-parkinsons-disease-impact-on-motor-symptoms-gait-cognitive-function-and-falls-a-systematic-review-and-meta-analysis-of-double-blind-placebo-contro/