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Cholinesterase Inhibitors Beneficial for Dementia With Lewy Bodies

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Use of ChEIs significantly slowed cognitive decline at follow-ups compared with memantine and nonuse

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Aug. 28, 2024 (HealthDay News) — Cholinesterase inhibitors (ChEIs) are beneficial for patients with dementia with Lewy bodies (DLB), according to a study published online Aug. 23 in Alzheimer’s & Dementia.

Hong Xu, M.D., Ph.D., from the Center for Alzheimer Research at the Karolinska Institutet in Stockholm, and colleagues examined the impact of ChEIs and memantine on cognition, major adverse cardiovascular events, and mortality in patients with DLB. Data were included from 1,095 incident DLB patients. The effect of initiating a ChEI or memantine within 90 days of DLB diagnosis and nonuse was assessed.

The researchers found that compared with memantine and nonuse, use of ChEIs significantly slowed cognitive decline at follow-ups (Mini-Mental State Examination, −0.39 points per year versus −2.49 and −2.50 points per year, respectively). No difference in major adverse cardiovascular events was seen for the treatment groups. There was an association observed for ChEI use with a lower risk for death in the first year after DLB diagnosis (adjusted hazard ratio, 0.66).

“Future studies are needed to better elucidate these mechanisms,” the authors write. “Clinical trials should be conducted for longer than two years of follow-up to assess long-term outcomes such as cardiovascular events and mortality.”

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