- 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
- 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