Effect of acetylcholinesterase inhibitors on post-stroke cognitive impairment and vascular dementia: A meta-analysis

• Published in: PloS one 2020-02, Vol.15 (2), p.e0227820-e0227820
• Main Authors: Kim, Jin Ok, Lee, Soo Joo, Pyo, Jung-Soo
• Format: Article
• Language: English
• Subjects: Acetylcholinesterase; Adult; Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer's disease; Analysis; Augmentation; Biology and Life Sciences; Care and treatment; Cholinergics; Cholinesterase; Cholinesterase inhibitors; Cholinesterase Inhibitors - adverse effects; Cholinesterase Inhibitors - pharmacology; Cholinesterase Inhibitors - therapeutic use; Cognition; Cognition & reasoning; Cognitive ability; Cognitive Dysfunction - drug therapy; Cognitive Dysfunction - etiology; Dementia; Dementia disorders; Dementia, Vascular - drug therapy; Dementia, Vascular - etiology; Diseases; Enzyme inhibitors; Female; Humans; Impairment; Inhibitors; Male; Medicine; Medicine and Health Sciences; Mental Status and Dementia Tests; Meta-analysis; Middle Aged; Neurodegenerative diseases; Pharmaceuticals; Physical Sciences; Research and Analysis Methods; Side effects; Stroke; Stroke - complications; Studies; Vascular dementia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0227820

Cognitive impairment is a common complication observed after a stroke. Currently there are no definitively proven pharmacologic therapies for recovery from post-stroke cognitive impairment and vascular dementia. In this meta-analysis, we evaluated the efficacy and safety of cholinesterase inhibitors in their improvement of cognition in patients with post-stroke cognitive impairment and vascular dementia. We conducted a meta-analysis using seven eligible studies from 305 published articles. We investigated the differences in Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) scores, before and after cholinergic augmentation in patients with post-stroke cognitive impairment and vascular dementia. MMSE and ADAS-cog scores were also compared during the subsequent follow-up periods. MMSE score of patients with post-stroke cognitive impairment was increased after cholinergic augmentation throughout the 24 weeks with mean differences [MD] of 3.000, 1.732, 1.578 1.516, and 1.222, at 4, 4-8, 8-12, 12-18, and 18-24 weeks, respectively. In addition, ADAS-cog scores decreased at 6, 12, 18, and 24 weeks by pharmaceutical augmentation, but not with placebo with mean differences [MD] of -2.333, -2.913, -2.767, -2.416, and -1.859, respectively. This meta-analysis shows that acetylcholinesterase inhibitors maintain a stable pattern of improved cognitive function in patients with post stroke cognitive impairment and vascular dementia without the increased risk of side effects.