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., ...Daha Fazla

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, cilt.87, sa.12, ss.1368-1374, 2016 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Cilt numarası: 87 Konu: 12
  • Basım Tarihi: 2016
  • Doi Numarası: 10.1136/jnnp-2016-313660
  • Dergi Adı: JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
  • Sayfa Sayıları: ss.1368-1374

Özet

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.