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Randomized Controlled Trial
. 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

Meera Sheffrin  1 , Yinghui Miao  1 , W John Boscardin  1   2 , Michael A Steinman  1
Affiliations
Randomized Controlled Trial

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

Meera Sheffrin et al. J Am Geriatr Soc. 2015 Aug.

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.

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Conflict of interest statement

Conflict of Interest: None of the authors report any conflicts of interest or financial relationships to disclose. Please see accompanying COI checklist.

Elements of Financial/Personal ConflictsAuthor 1 – Meera SheffrinAuthor 2 – Yinghui MiaoAuthor 3- W. John BoscardinAuthor 4 – Michael A. Steinman
YesNoYesNoYesNoYesNo
Employment or AffiliationXXXX
Grants/FundsXXXX
HonorariaXXXX
Speaker ForumXXXX
ConsultantXXXX
StocksXXXX
RoyaltiesXXXX
Expert TestimonyXXXX
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Figures

Figure 1
Figure 1. Time to >=10 pound weight loss in new users of cholinesterase inhibitors vs. matched controls
See this image and copyright information in PMC

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