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

• Published in: Scientific reports 2022-07, Vol.12 (1), p.12214-11, Article 12214
• Main Authors: Zuin, Marco, Cherubini, Antonio, Volpato, Stefano, Ferrucci, Luigi, Zuliani, Giovanni
• Format: Article
• Language: English
• Subjects: 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
• DOI: 10.1038/s41598-022-16476-w

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