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J. Neurol. Neurosurg. Psychiatr. · Dec 2016
Review Meta AnalysisAcetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis.
- Pinar Soysal, Ahmet Turan Isik, Brendon Stubbs, Marco Solmi, Marco Volpe, Claudio Luchini, Grazia D'Onofrio, Alberto Pilotto, Enzo Manzato, Giuseppe Sergi, Patricia Schofield, and Nicola Veronese.
- Faculty of Medicine, Department of Geriatric Medicine, Center for Aging Brain and Dementia, Dokuz Eylul University, Izmir, Turkey.
- J. Neurol. Neurosurg. Psychiatr. 2016 Dec 1; 87 (12): 1368-1374.
AbstractWe 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.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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