Cardiac Screening as a Prerequisite: Insights from A Cross-Sectional Observational Study of Dementia Patients Treated With 5 mg versus 10 mg Donepezil

Objective: To evaluate the effect of donepezil on resting heart rate in elderly dementia patients and compare HR changes between those prescribed 5 mg and 10 mg daily doses. Method: This cross-sectional observational study was conducted at the Geriatric OPD of the Department of Psychiatry of a tertiary healthcare centre in India from November 2024 to February 2025. Sixty dementia patients (≥60 years), who had been taking donepezil (5 mg or 10 mg daily) for at least one month, were included. Baseline HR (prior to starting donepezil) and follow-up HR were recorded. Patients were divided into two groups based on dose. Heart rate changes were compared within and between the groups. Subgroup analyses were performed based on age, sex, and co-morbidities. Results: Both groups showed significant reductions in HR from baseline (5 mg: 4.04 ± 2.30 bpm; 10 mg: 6.51 ± 2.49 bpm; p < 0.001). The 10 mg group had a significantly greater reduction compared to the 5 mg group (p = 0.002). Age, sex, and co-morbidities did not significantly influence HR change. Conclusion: Donepezil significantly reduces resting heart rate in a dose-dependent manner in elderly dementia patients. The drug appears safe and well-tolerated in routine outpatient care with appropriate monitoring.