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

SOYSAL, P., ISIK, A.T., STUBBS, B., SOLMI, M., VOLPE, M., LUCHINI, C., D'ONOFRIO, G., PILOTTO, A., MANZATO, E., SERGI, G., SCHOFIELD, Patricia and VERONESE, N. (2016). Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: A systematic review and meta-analysis. Journal of Neurology, Neurosurgery and Psychiatry, 87 (12), 1368-1374.

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Official URL: https://jnnp.bmj.com/content/87/12/1368
Link to published version:: https://doi.org/10.1136/jnnp-2016-313660
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    Abstract

    © 2016 Published by the BMJ Publishing Group Limited. 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.

    Item Type: Article
    Uncontrolled Keywords: ALZHEIMER'S DISEASE; DEMENTIA; GERIATRICS; META-ANALYSIS; Aged; Alzheimer Disease; Cholinesterase Inhibitors; Female; Humans; Male; Randomized Controlled Trials as Topic; Risk Assessment; Weight Loss; Humans; Alzheimer Disease; Weight Loss; Cholinesterase Inhibitors; Risk Assessment; Aged; Female; Male; Randomized Controlled Trials as Topic; 11 Medical and Health Sciences; 17 Psychology and Cognitive Sciences; Neurology & Neurosurgery
    Identification Number: https://doi.org/10.1136/jnnp-2016-313660
    Page Range: 1368-1374
    SWORD Depositor: Symplectic Elements
    Depositing User: Symplectic Elements
    Date Deposited: 19 Nov 2020 17:42
    Last Modified: 17 Mar 2021 20:16
    URI: http://shura.shu.ac.uk/id/eprint/27327

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