Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis - PubMed (original) (raw)
Review
. 2016 Dec;87(12):1368-1374.
doi: 10.1136/jnnp-2016-313660. Epub 2016 Jun 3.
Ahmet Turan Isik 1, Brendon Stubbs 2 3 4, Marco Solmi 5 6, Marco Volpe 7, Claudio Luchini 8 9, Grazia D'Onofrio 10, Alberto Pilotto 11, Enzo Manzato 12, Giuseppe Sergi 12, Patricia Schofield 4, Nicola Veronese 12
Affiliations
- PMID: 27261502
- DOI: 10.1136/jnnp-2016-313660
Review
Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis
Pinar Soysal et al. J Neurol Neurosurg Psychiatry. 2016 Dec.
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 meta-analysed. 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; 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 to 3.17, p<0.0001; I2=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.
Keywords: ALZHEIMER'S DISEASE; DEMENTIA; GERIATRICS; META-ANALYSIS.
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