Risk of falls with antipsychotics and cholinesterase inhibitors not higher than pretreatment

2021 ◽  
Vol 33 (1) ◽  
pp. 8-8
Keyword(s):  
Cholinesterase Inhibitors ◽  
Risk Of Falls

scholarly journals Use of antipsychotic drugs and cholinesterase inhibitors and risk of falls and fractures: self-controlled case series

BMJ ◽  
2021 ◽  
pp. n1925
Author(s):  
Grace Hsin-Min Wang ◽  
Kenneth K C Man ◽  
Wei-Hung Chang ◽  
Tzu-Chi Liao ◽  
Edward Chia-Cheng Lai
Keyword(s):  
Confidence Interval ◽  
Incidence Rate ◽  
Treatment Period ◽  
Cholinesterase Inhibitors ◽  
Antipsychotic Drugs ◽  
Case Series ◽  
Neurocognitive Disorders ◽  
Close Monitoring ◽  
Pretreatment Period ◽  
Risk Of Falls

Abstract Objective To evaluate the association between the use of antipsychotic drugs and cholinesterase inhibitors and the risk of falls and fractures in elderly patients with major neurocognitive disorders. Design Self-controlled case series. Setting Taiwan’s National Health Insurance Database. Participants 15 278 adults, aged ≥65, with newly prescribed antipsychotic drugs and cholinesterase inhibitors, who had an incident fall or fracture between 2006 and 2017. Prescription records of cholinesterase inhibitors confirmed the diagnosis of major neurocognitive disorders; all use of cholinesterase inhibitors was reviewed by experts. Main outcome measures Conditional Poisson regression was used to derive incidence rate ratios and 95% confidence intervals for evaluating the risk of falls and fractures for different treatment periods: use of cholinesterase inhibitors alone, antipsychotic drugs alone, and a combination of cholinesterase inhibitors and antipsychotic drugs, compared with the non-treatment period in the same individual. A 14 day pretreatment period was defined before starting the study drugs because of concerns about confounding by indication. Results The incidence of falls and fractures per 100 person years was 8.30 (95% confidence interval 8.14 to 8.46) for the non-treatment period, 52.35 (48.46 to 56.47) for the pretreatment period, and 10.55 (9.98 to 11.14), 10.34 (9.80 to 10.89), and 9.41 (8.98 to 9.86) for use of a combination of cholinesterase inhibitors and antipsychotic drugs, antipsychotic drugs alone, and cholinesterase inhibitors alone, respectively. Compared with the non-treatment period, the highest risk of falls and fractures was during the pretreatment period (adjusted incidence rate ratio 6.17, 95% confidence interval 5.69 to 6.69), followed by treatment with the combination of cholinesterase inhibitors and antipsychotic drugs (1.35, 1.26 to 1.45), antipsychotic drugs alone (1.33, 1.24 to 1.43), and cholinesterase inhibitors alone (1.17, 1.10 to 1.24). Conclusions The incidence of falls and fractures was high in the pretreatment period, suggesting that factors other than the study drugs, such as underlying diseases, should be taken into consideration when evaluating the association between the risk of falls and fractures and use of cholinesterase inhibitors and antipsychotic drugs. The treatment periods were also associated with a higher risk of falls and fractures compared with the non-treatment period, although the magnitude was much lower than during the pretreatment period. Strategies for prevention and close monitoring of the risk of falls are still necessary until patients regain a more stable physical and mental state.

The effect of cholinesterase inhibitors on the risk of falls and injuries in patients with mild to moderate Alzheimer���s dementia

2001 ◽  
Author(s):  
Heckman GA ◽  
Papaioannou A ◽  
Gagnon M ◽  
Olatunji S
Keyword(s):  
Cholinesterase Inhibitors ◽  
Risk Of Falls

Assessing Cholinesterase Inhibitors

2007 ◽  
Vol 40 (18) ◽  
pp. 8-9
Author(s):  
THOMAS FINUCANE
Keyword(s):  
Cholinesterase Inhibitors

Treatment of vertebral fractures due to osteoporosis

2015 ◽  
Vol 24 (01) ◽  
pp. 7-10 ◽  
Author(s):  
M. Pfeifer ◽  
M. Sinaki
Keyword(s):  
Exercise Program ◽  
Therapeutic Exercise ◽  
Training Support ◽  
Axial Stability ◽  
Extensor Muscles ◽  
Therapeutic Exercises ◽  
Increase Risk ◽  
Risk Of Falls ◽  
Risk Of Fall

SummaryThe objective of exercise in the treatment of osteoporosis is to improve axial stability through strengthening of back extensor muscles. Therefore, a back extension exercise program specific to one’s musculoskeletal competence and pain can be performed in a sitting position and later advanced to the prone position. When fragility is resolved, back extension is performed against resistance applied to the upper back. A significant reduction in back pain, kyphosis, and risk of falls and an improvement in the level of physical activity have been achieved through the SPEED (Spinal Proprioceptive Extension Exercise Dynamic) program. In addition, the application of a “Posture Training Support” (PTS) using a backpack may decrease kyphosis and pain related not only to compression fractures but also reduce iliocostal friction. Therapeutic exercise should address osteo - porosis-related deformities of axial posture, which can increase risk of fall and fracture. Thus, the role of a therapeutic exercise program is to increase muscle strength safely, decrease immobility-related complications, and prevent fall and fracture. As with pharmacotherapy, therapeutic exercises are individualized.

Dementia with Lewy bodies

2018 ◽  
pp. 11-21
Author(s):  
O. S. Levin ◽  
E. E. Vasenina ◽  
A. Sh. Chimagomedova ◽  
N. G. Dudchenko
Keyword(s):  
Parkinson’S Disease ◽  
Dementia With Lewy Bodies ◽  
Cholinesterase Inhibitors ◽  
Lewy Bodies ◽  
Diagnosis And Treatment ◽  
Modern Concept ◽  
Historical Aspect ◽  
Neurodegenerative Process ◽  
Icd 10

Te lecture presents modern concept of the symptoms, diagnosis and treatment of dementia with Lewy bodies (DLB), which accounts for about 10% of cases of dementia. Te nosological status of DLB and the problem of ratio of DLB and Parkinson’s disease which, apparently, represent two phenotypic variants of one neurodegenerative process («diseases with Lewy bodies») are considered in historical aspect. Approaches to the diagnosis and coding of DLB in accordance with ICD-10 are proposed. Te role of cholinesterase inhibitors, antipsychotics, levodopa, rasagiline and other drugs in the treatment of patients with DLB is аnalyzed.

Rationale for the Development of Cholinesterase Inhibitors as Anti- Alzheimer Agents

2004 ◽  
Vol 10 (25) ◽  
pp. 3111-3119 ◽  
Author(s):  
D. Lahiri ◽  
J. Rogers ◽  
N. Greig ◽  
K. Sambamurti
Keyword(s):  
Cholinesterase Inhibitors

Recent Knowledge on Medicinal Plants as Source of Cholinesterase Inhibitors for the Treatment of Dementia

2016 ◽  
Vol 16 (8) ◽  
pp. 605-618 ◽  
Author(s):  
Rosa Tundis ◽  
Marco Bonesi ◽  
Francesco Menichini ◽  
Monica R. Loizzo
Keyword(s):  
Medicinal Plants ◽  
Cholinesterase Inhibitors
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