Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis

Soysal, Pinar and Isik, Ahmet T. and Stubbs, Brendon and Solmi, Marco and Volpe, Marco and Luchini, Claudio and D'Onofrio, Grazia and Pilotto, Alberto and Manzato, Enzo and Sergi, Giuseppe and Schofield, Patricia and Veronese, Nicola (2016) Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry, 87 (12). pp. 1368-1374. ISSN 1468-330X

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Official URL: http://doi.org/10.1136/jnnp-2016-313660

Abstract

We conducted a systematic review and meta-analysis investigating the influence of AChEIs therapy on nutritional status and weight across observational and interventional studies. Two authors searched major electronic databases from inception until 10/14/2015 for longitudinal, open-label and randomized double blind placebo controlled (RCTs) studies of AChEIs in patients with dementia reporting nutritional status outcome data. Out of 3,551 initial hits, 25 studies (12 open-label trials, 9 RCTs and 4 longitudinal studies) including 10,792 patients with dementia were meta analyzed. In longitudinal studies (median follow-up: 6 months), a significant cumulative incidence of weight loss between baseline and follow-up evaluation was observed (studies=2; 5%; 95%CI: 1-34%, p<0.0001; I2=95%). These findings were confirmed in open-label trials (6%; 95%CI: 4-7%, p<0.0001; I2=78%). In 9 RCTs (median follow-up: 5 months), those taking AChEIs more frequently experienced weight loss than participants taking placebo (OR=2.18; 95%CI: 1.50-3.17, p<0.0001; I2=29%). AChEIs therapy contributes to weight loss in patients with dementia, with a twofold increased risk observed in the meta-analysis of RCTs. Clinicians should carefully consider the benefit and risk of prescribing AChEIs. Nutritional status should be routinely evaluated in patients with dementia treated with AChEIs.

Item Type: Journal Article
Keywords: Dementia, Alzheimers Disease, Acetylcholinesterase
Faculty: Faculty of Health, Social Care & Education (for research post September 2011)
Depositing User: Prof Pat Schofield
Date Deposited: 20 Jun 2016 10:06
Last Modified: 21 Feb 2019 12:18
URI: http://arro.anglia.ac.uk/id/eprint/700019

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