ChEI Helps Lewy-body Dementia

McKnights’ reported that researchers with the Karolinska Institute in Stockholm, Sweden, found that a class of drugs commonly used to treat Alzheimer’s and other dementias for nursing homes residents, has been found to slow cognitive decline over a five-year period in patients that are diagnosed with Lewy body dementia. The researchers compared cholinesterase inhibitors (ChEI) to memantine treatment and no use of the drugs in more than 1,00 patients. 

According to the authors, Lewy body dementia is one of the most common forms of dementia and accounts for 10%-15% of dementia cases. ChEI and memantine are also used to treat Parkinson’s disease, which is a risk factor for Lewy body dementia. 

This study examined long-term cognitive changes, the risk of major adverse cardiovascular events, and death within 90 days of being diagnosed with Lewy body dementia. Additionally, five-year outcomes were compared between patients that were treated with the three ChEI drugs, those with memantine, and those who did not receive treatment at all.

The results below support a change in guideline recommendations of ChEI in Lewy body dementia. This study was published in the journal Alzheimer’s & Dementia. 

Results: 

Patient’s who were treated with donepezil and galantamine, but not rivastigmine, showed a significant improvement of scores on the Mini Mental State Examination. There was no change in cognitive score for people taking memantine. 

Lead author, Hong Zu, PhD and colleagues, found that higher ChEI doses were associated with greater cognitive benefits. There was a significantly lower incidence of death with rivastigmine treatment, but only in the first year. No effect was found for major cardiovascular events.