Author Response: Long-term Effects of Cholinesterase Inhibitors on Cognitive Decline and Mortality

Neurology ◽  
2021 ◽  
Vol 97 (20) ◽  
pp. 965.1-965
Author(s):  
Hong Xu ◽  
Sara Garcia-Ptacek ◽  
Maria Eriksdotter
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lizhen Han ◽  
Jinzhu Jia

Abstract Background In the context of increasing global aging, the long-term effects of alcohol consumption on cognitive function in older adults were analyzed in order to provide rationalized health recommendations to the elderly population. Methods The study used the Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset, from which 5354 Chinese seniors aged 65–112 years were selected as the subjects, spanning the years 1998–2018. Data on alcohol, diet, activity, and cognition were collected by questionnaire and cognitive levels were judged by the Mini-Mental State Examination scale (also referenced to the Functional Assessment Staging Test). Data cleaning and preprocessing was implemented by R software. The dynamic Cox model was applied for model construction and data analysis. Results The results of the dynamic Cox model suggested that seniors who drank alcohol were at higher risk of cognitive decline compared to those who never drank (HR = 1.291, 95%CI: 1.175–1.419). The risk was similarly exacerbated by perennial drinking habits (i.e., longer drinking years, HR = 1.008, 95%CI: 1.004–1.013). Compared to non-alcoholic beverages, liquor (≥ 38°), liquor (< 38°), wine and rice wine all showed negative effects. Whereas, the risk of cognitive decline was relatively lower in seniors who consumed liquors (< 38°) and rice wine compared to the high-level liquor (HR: 0.672 (0.508, 0.887) and 0.732 (0.559, 0.957), respectively). Conclusions Alcohol consumption has a negative and long-term effects on cognitive function in seniors. For the elderly, we suggested that alcohol intake should be avoided as much as possible.


Neurology ◽  
2021 ◽  
Vol 97 (23) ◽  
pp. 1095-1095
Author(s):  
Tian-Shin Yeh ◽  
Changzheng Yuan ◽  
Alberto Ascherio ◽  
Bernard A. Rosner ◽  
Walter C. Willett ◽  
...  

2019 ◽  
Vol 27 (6) ◽  
pp. 918-934 ◽  
Author(s):  
Jennifer L. Robinson ◽  
John M. Hunter ◽  
Tania Reyes-Izquierdo ◽  
Ruby Argumedo ◽  
Jessica Brizuela-Bastien ◽  
...  

Neurology ◽  
2021 ◽  
Vol 96 (17) ◽  
pp. e2220-e2230 ◽  
Author(s):  
Hong Xu ◽  
Sara Garcia-Ptacek ◽  
Linus Jönsson ◽  
Anders Wimo ◽  
Peter Nordström ◽  
...  

ObjectiveTo investigate whether cholinesterase inhibitors (ChEIs) are associated with slower cognitive decline in Alzheimer dementia and decreased risk of severe dementia or death.MethodsPatients with Alzheimer dementia from the Swedish Dementia Registry starting on ChEIs within 3 months of the dementia diagnosis were included and compared to nontreated patients with Alzheimer dementia. In a propensity score–matched cohort, the association between ChEI use and cognitive trajectories assessed by Mini-Mental State Examination (MMSE) scores was examined with a mixed model, and severe dementia (MMSE score <10) or death as an outcome was assessed with Cox proportional hazards models.ResultsThe matched cohort included 11,652 ChEI users and 5,826 nonusers. During an average of 5 years of follow-up, 255 cases developed severe dementia, and 6,055 (35%) died. ChEI use was associated with higher MMSE score at each visit (0.13 MMSE points per year; 95% confidence interval [CI] 0.06–0.20). ChEI users had a 27% lower risk of death (0.73, 95% CI 0.69–0.77) compared with nonusers. Galantamine was associated with lower risk of death (0.71, 95% CI 0.65–0.76) and lower risk of severe dementia (0.69, 95% CI 0.47–1.00) and had the strongest effect on cognitive decline of all the ChEIs (0.18 MMSE points per year, 95% CI 0.07–0.28).ConclusionsChEIs are associated with cognitive benefits that are modest but persist over time and with reduced mortality risk, which could be explained partly by their cognitive effects. Galantamine was the only ChEI demonstrating a significant reduction in the risk of developing severe dementia.Classification of EvidenceThis study provides Class III evidence that for patients with Alzheimer dementia ChEIs decrease long-term cognitive decline and risk of death and that galantamine decreases the risk of severe dementia.


2020 ◽  
Author(s):  
Giovanna Sarra ◽  
Itamara Lucia Itagiba Neves ◽  
Maria Stella Moreira ◽  
Marcela Alves dos Santos‐Paul ◽  
Tânia Cristina Pedroso Montano ◽  
...  

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