Cholinesterase inhibitors for alzheimer disease: Do they provide more than symptomatic benefits?

Guk Hee Suh, Seung Ho Ryu, Dong Woo Lee, Changsu Han, Young Su Ju, Baik Seok Kee, Joon Noh Lee, Jae Nam Bae, Jong Hyuk Choi, Dai Jin Kim, Nam Jin Lee, Jun Young Lee, Hyo Jin Go, Jung Seo Yi, Seong Jin Cho, Yang Whan Jeon

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Abstract

Objective: This study aims to examine survival of patients with Alzheimer disease (AD) receiving clinical efficacy of cholinesterase inhibitors (ChEIs) and to compare their survival with those of patients with AD who never received ChEIs and cogni- tively intact old psychiatric outpatients. Design, setting, and Participants: The retrospective cohort study used national mortality data provided by the Korean National Statistics Office and electronic database of 15 general hospitals on older patients who began outpatient treatment with psychiatric medications including ChEIs (N = 3,813). The authors controlled for confounding by using multivariate models and propensity scoring methods. Measurements: Mortality rate of patients with AD receiving ChEIs was compared with those of patients with AD who never received ChEIs and cognitively intact old psychiatric outpatients. Results: Observed additional survival of patients with AD receiving ChEIs (mortality rate: 13.1%), when compared with patients with AD who never received ChEIs (15.4%) was not statistically significant (p = 0.74; hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 0.67-1.59). Patients with AD receiving ChEIs showed higher mortality rate (13.1%) compared with that of cognitively intact old psychiatric outpatients (8.6%) (p <0.001; HR: 1.60, 95% CI: 0.96-2.68). Conclusion: This study does not support that ChEIs increase survival of patients with AD, compared with patients with AD who have never treated with ChEIs. Therefore, all ChEIs should be considered for symptomatic use only and not to be capable of modifying mortality of patients with AD.

Original languageEnglish
Pages (from-to)266-273
Number of pages8
JournalAmerican Journal of Geriatric Psychiatry
Volume19
Issue number3
DOIs
Publication statusPublished - 2011 Jan 1

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Keywords

  • Alzheimer disease
  • Cholinesterase inhibitors
  • mortality

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Suh, G. H., Ryu, S. H., Lee, D. W., Han, C., Ju, Y. S., Kee, B. S., Lee, J. N., Bae, J. N., Choi, J. H., Kim, D. J., Lee, N. J., Lee, J. Y., Go, H. J., Yi, J. S., Cho, S. J., & Jeon, Y. W. (2011). Cholinesterase inhibitors for alzheimer disease: Do they provide more than symptomatic benefits? American Journal of Geriatric Psychiatry, 19(3), 266-273. https://doi.org/10.1097/JGP.0b013e3181e56d30