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
(2024) In Alzheimer's and Dementia 20(10). p.6740-6754- Abstract
INTRODUCTION: 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). METHODS: 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. RESULTS: 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... (More)
INTRODUCTION: 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). METHODS: 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. RESULTS: 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). DISCUSSION: Our findings illuminate the potential benefits of ChEI treatment in DLB patients. Highlights: 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.
(Less)
- author
- Xu, Hong ; Habich, Annegret ; Ferreira, Daniel ; Elisabet, Londos LU ; Westman, Eric and Eriksdotter, Maria
- organization
- publishing date
- 2024-10
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cholinesterase inhibitors, dementia with Lewy bodies, memantine, MMSE, mortality
- in
- Alzheimer's and Dementia
- volume
- 20
- issue
- 10
- pages
- 15 pages
- publisher
- Wiley
- external identifiers
-
- scopus:85201795026
- pmid:39177108
- ISSN
- 1552-5260
- DOI
- 10.1002/alz.14118
- language
- English
- LU publication?
- yes
- id
- 81def4b3-7aef-47bc-82d6-e710912ec884
- date added to LUP
- 2024-11-01 09:54:30
- date last changed
- 2025-07-12 21:35:09
@article{81def4b3-7aef-47bc-82d6-e710912ec884,
abstract = {{<p>INTRODUCTION: 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). METHODS: 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. RESULTS: 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). DISCUSSION: Our findings illuminate the potential benefits of ChEI treatment in DLB patients. Highlights: 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.</p>}},
author = {{Xu, Hong and Habich, Annegret and Ferreira, Daniel and Elisabet, Londos and Westman, Eric and Eriksdotter, Maria}},
issn = {{1552-5260}},
keywords = {{cholinesterase inhibitors; dementia with Lewy bodies; memantine; MMSE; mortality}},
language = {{eng}},
number = {{10}},
pages = {{6740--6754}},
publisher = {{Wiley}},
series = {{Alzheimer's and Dementia}},
title = {{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}},
url = {{http://dx.doi.org/10.1002/alz.14118}},
doi = {{10.1002/alz.14118}},
volume = {{20}},
year = {{2024}},
}