ArticleCNS drugs2010
Predictive factors of discontinuation and switch of cholinesterase inhibitors in community-dwelling patients with Alzheimer's disease: a 2-year prospective, multicentre, cohort study.
Article in CNS drugs, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Concurrent Use of Anticholinergic and Antidementia Medicines in Older Adults with Dementia: A Systematic Review of Prevalence, Predictors and Clinical Outcomes.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Adherence and Tolerability of Alzheimer's Disease Medications: A Pragmatic Randomized Trial.Journal of the American Geriatrics Society · 2017Trial
- Characterization of hepatic enzyme activity in older adults with dementia: potential impact on personalizing pharmacotherapy.Clinical interventions in aging · 2015Trial
- Down syndrome and dementia: a randomized, controlled trial of antioxidant supplementation.American journal of medical genetics. Part A · 2011Trial
- Treatment patterns of symptomatic treatments for Alzheimer's disease and related dementias.BMC geriatrics · 2025Article
- Strategies for Continued Successful Treatment in Patients with Alzheimer's Disease: An Overview of Switching Between Pharmacological Agents.Current Alzheimer research · 2018Review
- Community Pharmacists' Knowledge Regarding Donepezil Averse Effects and Self-Care Recommendations for Insomnia for Persons with AD.Pharmacy (Basel, Switzerland) · 2017Article
- Persistence and adherence with dementia pharmacotherapy: relevance of patient, provider, and system factors.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2014Review
- Article
- Effect of long-term treatment with galantamine on weight of patients with Alzheimer's dementia.The journal of nutrition, health & aging · 2013Article
- Predictors of decline in walking ability in community-dwelling Alzheimer's disease patients: Results from the 4-years prospective REAL.FR study.Alzheimer's research & therapy · 2013Article
- Relations between cognitive status and medication adherence in patients treated for memory disorders.Ageing research · 2012Article
- Tailored Information and Automated Reminding to Improve Medication Adherence in Spanish- and English-Speaking Elders Treated for Memory Impairment.Clinical gerontologist · 2012Article
- Alzheimer disease: clinical use of cholinergic drugs in Alzheimer disease.Nature reviews. Neurology · 2010Article
- Comedication and Treatment Length in Users of Acetylcholinesterase Inhibitors.Dementia and geriatric cognitive disorders extraArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe efficacy of cholinesterase inhibitors (ChEIs), especially over the long term, is still under discussion. There is a lack of data concerning the optimal drug treatment duration and the reasons for discontinuation, particularly outside the clinical trial setting.
objectiveTo identify predictive factors of discontinuation and switch of ChEIs in a real-world setting.
methodsA multicentre cohort study of 686 patients with mild-to-moderate ambulatory Alzheimer's disease who were diagnosed in 16 Alzheimer's disease expert centres in 2000-2 and who were assessed twice yearly for 2 years. The main outcome measure was ChEI discontinuation and switch (analysed using Cox survival analyses).
resultsAfter 2 years, of the 611 subjects treated with a ChEI at baseline, 100 subjects had switched or discontinued ChEI therapy (incidence rate 12.7 [95% CI 10.2, 15.2] per 100 person-years). The incidences of switching and discontinuation were 9.2 (95% CI 7.0, 11.3) and 3.6 (95% CI 2.3, 4.8) per 100 person-years, respectively. In the multivariate analysis, predictive factors for switching were an ineffective ChEI dose (adjusted hazard ratio [HR(a)] = 6.91, 95% CI 3.08, 15.49), rapid cognitive decline (HR(a) = 4.10, 95% CI 1.85, 9.05), hospitalization unrelated to Alzheimer's disease (HR(a) = 2.33, 95% CI 1.07, 5.09) and anxiety (HR(a) = 2.08, 95% CI 1.16, 3.73). Predictive factors of discontinuation were: hospitalization related (HR(a) = 9.14, 95% CI 2.69, 31.07) or unrelated (HR(a) = 4.23, 95% CI 1.54, 11.59) to Alzheimer's disease, use of an anticholinergic drug (HR(a) = 4.26, 95% CI 1.46, 12.45) and weight loss (HR(a) = 3.77, 95% CI 1.15, 12.33).
conclusionsThis study highlights four types of predictors of switch or discontinuation, reflecting disease progression, reconsideration of ChEI benefits, adverse drug reactions to ChEIs and inappropriate concurrent use of anticholinergic drugs. Attention should be paid to anticholinergic agents and prescribers should be given better information about these drugs.
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