2024-08-23 カロリンスカ研究所(KI)
<関連情報>
- https://news.ki.se/alzheimers-drug-may-slow-down-cognitive-decline-in-dementia-with-lewy-bodies
- https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.14118
レビー小体型認知症における認知機能低下、心血管イベント、死亡率に対するコリンエステラーゼ阻害薬とメマンチンの長期効果: 10年までの追跡調査 Long-term effects of cholinesterase inhibitors and memantine on cognitive decline, cardiovascular events, and mortality in dementia with Lewy bodies: An up to 10-year follow-up study
Hong Xu, Annegret Habich, Daniel Ferreira, Londos Elisabet, Eric Westman, Maria Eriksdotter
Alzheimer’s & Dementia Published: 23 August 2024
DOI:https://doi.org/10.1002/alz.14118
Abstract
INTRODUCTION
We aimed to assess the impact of cholinesterase inhibitors (ChEIs) and memantine on cognition, major adverse cardiovascular events (MACE) and mortality in dementia with Lewy bodies (DLB).
METHODS
A total of 1,095 incident DLB patients from the Swedish Registry on cognitive/dementia disorders were included. Using an inverse probability of treatment weighting, the effect of initiating ChEI or memantine within 90 days of DLB diagnosis and nonuse was evaluated on cognitive trajectories and risks of MACE and death.
RESULTS
The use of ChEIs significantly slowed cognitive decline at follow-ups (Mini-Mental State Examination [MMSE] -0.39 points/y; 95% confidence interval [CI], -0.96 to 0.18) compared to memantine (-2.49 points/y; -4.02 to -0.97) and nonuse (-2.50 points/y; -4.28 to -0.73). Treatment groups did not differ in MACE events. ChEI use was associated with lower risk of death in the first year after DLB diagnosis (adjusted hazard ratio [HR] 0.66, 95% CI 0.46, 0.94).
DISCUSSION
Our findings illuminate the potential benefits of ChEI treatment in DLB patients.
Highlights
- Cholinesterase inhibitors slow cognitive decline over a 5-year follow-up period when compared to both memantine treatment and nonuse in patients with dementia with Lewy bodies.
- Cholinesterase Inhibitors reduce risk of mortality within the initial year, but this effect is not sustained after 1 year in patients with dementia with Lewy bodies.
