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J Am Geriatr Soc. 2015 Aug;63(8):1512-8. doi: 10.1111/jgs.13511. Epub 2015 Aug 3.

Weight Loss Associated with Cholinesterase Inhibitors in Individuals with Dementia in a National Healthcare System.

Author information

1
Division of Geriatrics, University of California at San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California.
2
Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.

Abstract

OBJECTIVES:

To determine whether initiation of cholinesterase inhibitors is associated with significant weight loss in a real-word clinical setting.

DESIGN:

Retrospective cohort study from 2007 to 2010 comparing weight loss in individuals with dementia newly prescribed cholinesterase inhibitors and those newly prescribed other chronic medications.

SETTING:

National Veterans Affairs data.

PARTICIPANTS:

Individuals aged 65 and older with a diagnosis of dementia who received a new prescription for a cholinesterase inhibitor or other new chronic medication.

MEASUREMENTS:

The primary outcome was time to 10-pound weight loss over 12 months. Propensity score matching was used to control for the likelihood of receiving a cholinesterase inhibitor based on baseline characteristics. Data were analyzed in a priori defined subgroups according to age, comorbid burden, and initial weight.

RESULTS:

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 (hazard ratio = 1.23, 95% confidence interval (CI) = 1.07-1.41). At 12 months, 29.3% of participants taking cholinesterase inhibitors had experienced weight loss, compared with 22.8% of nonusers, corresponding to a number needed to harm of 21.2 (95% CI = 12.5-71.4) over 1 year. There were no significant differences in the risk of weight loss within subgroups.

CONCLUSION:

These results are consistent with the available data from randomized controlled trials. Clinicians should consider the risk of weight loss when prescribing cholinesterase inhibitors.

KEYWORDS:

cholinesterase inhibitors; dementia; weight loss

PMID:
26234945
PMCID:
PMC4737921
DOI:
10.1111/jgs.13511
[Indexed for MEDLINE]
Free PMC Article

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