Long-term effects of cholinesterase inhibitors and memantine on cognitive decline, cardiovascular events, and mortality in dementia with Lewy bodies: An up to 10-year follow-up study.
MMSE
cholinesterase inhibitors
dementia with Lewy bodies
memantine
mortality
Journal
Alzheimer's & dementia : the journal of the Alzheimer's Association
ISSN: 1552-5279
Titre abrégé: Alzheimers Dement
Pays: United States
ID NLM: 101231978
Informations de publication
Date de publication:
23 Aug 2024
23 Aug 2024
Historique:
revised:
18
05
2024
received:
16
02
2024
accepted:
31
05
2024
medline:
23
8
2024
pubmed:
23
8
2024
entrez:
23
8
2024
Statut:
aheadofprint
Résumé
We aimed to assess the impact of cholinesterase inhibitors (ChEIs) and memantine on cognition, major adverse cardiovascular events (MACE) and mortality in dementia with Lewy bodies (DLB). A total of 1,095 incident DLB patients from the Swedish Registry on cognitive/dementia disorders were included. Using an inverse probability of treatment weighting, the effect of initiating ChEI or memantine within 90 days of DLB diagnosis and nonuse was evaluated on cognitive trajectories and risks of MACE and death. The use of ChEIs significantly slowed cognitive decline at follow-ups (Mini-Mental State Examination [MMSE] -0.39 points/y; 95% confidence interval [CI], -0.96 to 0.18) compared to memantine (-2.49 points/y; -4.02 to -0.97) and nonuse (-2.50 points/y; -4.28 to -0.73). Treatment groups did not differ in MACE events. ChEI use was associated with lower risk of death in the first year after DLB diagnosis (adjusted hazard ratio [HR] 0.66, 95% CI 0.46, 0.94). Our findings illuminate the potential benefits of ChEI treatment in DLB patients. Cholinesterase inhibitors slow cognitive decline over a 5-year follow-up period when compared to both memantine treatment and nonuse in patients with dementia with Lewy bodies. Cholinesterase Inhibitors reduce risk of mortality within the initial year, but this effect is not sustained after 1 year in patients with dementia with Lewy bodies.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Strategic Research Area Neuroscience-Karolinska Institutet
Organisme : Center for Innovative Medicine Foundation
ID : FoUI-963369
Organisme : Center for Innovative Medicina
ID : 20200505
Organisme : Center for Innovative Medicina
ID : FoUI-988826
Organisme : regional agreement on medical training and clinical research of Stockholm Region
ID : FoUI-962240
Organisme : regional agreement on medical training and clinical research of Stockholm Region
ID : FoUI-987534
Organisme : Swedish Brain Foundation
Organisme : Swedish Alzheimer Foundation
Organisme : Swedish Dementia Foundation
Organisme : Gamla Tjänarinnor Foundation
Organisme : Gun och Bertil Stohnes Foundation
Organisme : Karolinska Institutet, Neurofonden, and Foundation for Geriatric Diseases
Organisme : Swedish research council
ID : #2022-01428
Organisme : Swedish research council
ID : 2022-00916
Organisme : Swedish research council
ID : #2020-02014
Organisme : Swedish Innovation Agency
ID : 2021-02680
Informations de copyright
© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
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