Publication: Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis
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Date
2016-12-01T00:00:00Z
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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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Abstract
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.
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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