Acetyl-cholinesterase-inhibitors slow cognitive decline and decrease overall mortality in older patients with dementia

We evaluated the effect of Acetyl-cholinesterase-inhibitors (AChEIs) on cognitive decline and overall survival in a large sample of older patients with late onset Alzheimer’s disease (LOAD), vascular dementia (VD) or Lewy body disease (LBD) from a real world setting. Patients with dementia enrolled...

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Vydáno v:Scientific reports Ročník 12; číslo 1; s. 12214 - 11
Hlavní autoři: Zuin, Marco, Cherubini, Antonio, Volpato, Stefano, Ferrucci, Luigi, Zuliani, Giovanni
Médium: Journal Article
Jazyk:angličtina
Vydáno: London Nature Publishing Group UK 16.07.2022
Nature Publishing Group
Nature Portfolio
Témata:
631/378/2612
692/308/174
692/308/409
692/617/375
Aged
Alzheimer Disease - psychology
Alzheimer's disease
Cholinesterase
Cholinesterase Inhibitors - therapeutic use
Cholinesterases
Cognitive ability
Cognitive Dysfunction - chemically induced
Cognitive Dysfunction - drug therapy
Dementia
Dementia disorders
Humanities and Social Sciences
Humans
Lewy bodies
Lewy Body Disease
Mortality
multidisciplinary
Neurodegenerative diseases
Older people
Patients
Regression analysis
Science
Science (multidisciplinary)
Sexually transmitted diseases
STD
Vascular dementia
ISSN:2045-2322, 2045-2322
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Popis
Shrnutí:We evaluated the effect of Acetyl-cholinesterase-inhibitors (AChEIs) on cognitive decline and overall survival in a large sample of older patients with late onset Alzheimer’s disease (LOAD), vascular dementia (VD) or Lewy body disease (LBD) from a real world setting. Patients with dementia enrolled between 2005 and 2020 by the "Alzheimer's Disease Research Centers" were analysed; the mean follow-up period was 7.9 years. A 1:1 propensity score matching was performed generating a cohort of 1.572 patients (786 treated [AChEIs +] and 786 not treated [AChEIs-] with AChEIs. The MMSE score was almost stable during the first 6 years of follow up in AChEIs + and then declined, while in AChEIs− it progressively declined so that at the end of follow-up (13.6 years) the average decrease in MMSE was 10.8 points in AChEIs- compared with 5.4 points in AChEIs + ( p  < 0.001). This trend was driven by LOAD (Δ-MMSE:−10.8 vs. −5.7 points; p  < 0.001), although a similar effect was observed in VD (Δ-MMSE:−11.6 vs. −8.8; p  < 0.001). No effect on cognitive status was found in LBD. At multivariate Cox regression analysis (adjusted for age, gender, dependency level and depression) a strong association between AChEIs therapy and lower all-cause mortality was observed (H.R.:0.59; 95%CI: 0.53–0.66); this was confirmed also in analyses separately conducted in LOAD, VD and LBD. Among older people with dementia, treatment with AChEIs was associated with a slower cognitive decline and with reduced mortality, after a mean follow-up of almost eight years. Our data support the effectiveness of AChEIs in older patients affected by these types of dementia.
Bibliografie:ObjectType-Article-1
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-022-16476-w