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

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Soysal, PINAR
Isik, Ahmet Turan
Stubbs, Brendon
Solmi, Marco
Volpe, Marco
Luchini, Claudio
D'Onofrio, Grazia
Pilotto, Alberto
Manzato, Enzo
Sergi, Giuseppe
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We conducted a systematic review and meta-analysis investigating the influence of acetylcholinesterase inhibitors (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 randomised double-blind placebo controlled (randomised controlled trials (RCTs)) studies of AChEIs in patients with dementia reporting nutritional status outcome data. Out of 3551 initial hits, 25 studies (12 open-label trials, 9 RCTs and 4 longitudinal studies) including 10 792 patients with dementia were metaanalysed. 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% to 34%, p< 0.0001; I2= 95%). These findings were confirmed in open-label trials (6%; 95% CI 4% to 7%, p< 0.0001; I-2= 78%). In 9 RCTs (median followup 5 months), those taking AChEIs more frequently experienced weight loss than participants taking placebo (OR= 2.18; 95% CI 1.50 to 3.17, p< 0.0001; I-2= 29%). AChEIs therapy contributes to weight loss in patients with dementia, with a 2-fold 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.
Soysal P., Isik A. T. , Stubbs B., Solmi M., Volpe M., Luchini C., D-Onofrio G., Pilotto A., Manzato E., Sergi G., et al., -Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis-, JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, cilt.87, ss.1368-1374, 2016
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