Cholinesterase Inhibitors May Cause Dangerous Weight Loss in Dementia

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Cholinesterase inhibitors, used to treat dementia, may produce significant and potentially dangerous weight loss in patients, according to data published in the Journal of the American Geriatrics Society.

Meera Sheffrin, MD, of the University of California at San Francisco and San Francisco VA Medical Center, and colleagues conducted a retrospective cohort study from 2007 to 2010 to compare weight loss in people with dementia who were prescribed cholinesterase inhibitors and other medications. Participants were 65 years and older and had a diagnosis of dementia.

 In total, 6,504 people met study criteria, with 1,188 on cholinesterase inhibitors matched to 2,189 participants on other medications. Those taking the dementia drugs had a higher risk of weight loss than matched controls at 12 months (hazard ratio = 1.23, 95% confidence interval (CI)  = 1.07–1.41), with 29.3% of the cholinesterase group experiencing weight loss at 12 months compared to 22.8% of nonusers. This corresponded to a number needed to harm of 21.2 (95% CI = 12.5–71.4) over one year.

"This is very relevant to patient care because unintentional weight loss in older adults is associated with many adverse outcomes, including increased rates of institutionalization and mortality, a decline in functional status, and poorer quality of life," said Sheffrin.

Sick old woman
Cholinesterase Inhibitors May Cause Dangerous Weight Loss in Dementia

Meera Sheffrin, MD, of the University of California at San Francisco and San Francisco VA Medical Center, and colleagues conducted a retrospective cohort study from 2007 to 2010 to compare weight loss in people with dementia who were prescribed cholinesterase inhibitors and other medications.

Of 6,504 individuals that met study criteria, 1,188 started on cholinesterase inhibitors were matched to 2,189 started on other medications. The propensity-matched cohorts were well balanced on baseline covariates. Participants initiated on cholinesterase inhibitors had a higher risk of weight loss than matched controls at 12 months.

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