ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2023
Donepezil treatment is associated with improved outcomes in critically ill dementia patients via a reduction in delirium.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Acetylcholinesterase inhibitors and the risk of delirium - a Danish nationwide register-based cohort study.Alzheimer's research & therapy · 2026Article
- Overactive bladder medications and risk of emergency hospital admissions with delirium in adults without dementia: self-controlled case series.Age and ageing · 2025Article
- Characteristics, Complications, and Outcomes of Critical Illness in Patients with Parkinson Disease.Neurocritical care · 2025Article
- Clinical effect of donepezil hydrochloride in the treatment of Parkinson's disease patients: a meta-analysis.American journal of translational research · 2025Review
- The Relationship between Delirium and Dementia.Seminars in neurology · 2024Review
- Common molecular and pathophysiological underpinnings of delirium and Alzheimer's disease: molecular signatures and therapeutic indications.BMC geriatrics · 2024Article
- Antidementia Medication Use in Nursing Home Residents.Journal of geriatric psychiatry and neurology · 2024Article
- A Molecular Framework for Delirium.The Neurohospitalist · 2024Review
- Promising Effects of Montelukast for Critically Ill Asthma Patients via a Reduction in Delirium.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Impact of mechanical ventilation on clinical outcomes in ICU-admitted Alzheimer's disease patients: a retrospective cohort study.Frontiers in public health · 2024Article
- Mechanisms underlying delirium in patients with critical illness.Frontiers in aging neuroscience · 2024Review
- Association between statin use on delirium and 30-day mortality in patients with chronic obstructive pulmonary disease in the intensive care unit.European journal of medical research · 2023Article
- Reexamining cholinesterase inhibitors for the prevention and treatment of delirium in high-risk populations.Critical care (London, England) · 2023Article
- Associations Between Dysphagia and Adverse Health Outcomes in Older Adults with Dementia in Intensive Care Units: A Retrospective Cohort Study.Clinical interventions in aging · 2023Article
- Association between delirium and statin use in patients with congestive heart failure: a retrospective propensity score-weighted analysis.Frontiers in aging neuroscience · 2023Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
introductionDuring hospital admissions, patients with dementia are at risk for developing delirium, an acute state of brain failure associated with significant morbidity. There are currently no pharmacologic tools to treat or prevent delirium. Decreased cholinergic signaling plays a role in the pathophysiology of both disorders. Whether enhanced pre-hospital cholinergic signaling in patients with dementia improves outcomes during critical illness remains unknown.
methodsWe utilized the Medical Information Mart for Intensive Care III (MIMIC-III) database to determine whether pre-hospital donepezil use was associated with improved outcomes during critical illness in dementia patients.
resultsWe identified 2734 subjects with dementia admitted to the intensive care unit (ICU; 447 received donepezil). After adjusting for confounders, patients with dementia who were receiving donepezil had a significantly reduced in-hospital and 90-day mortality, ICU length of stay, and duration of mechanical ventilation. Donepezil use was associated with, and its benefit was mediated by, reduced delirium. DISCUSSION: Patients with dementia who are treated with donepezil have improved outcomes during critical illness and reductions in delirium. HIGHLIGHTS: No pharmacologic treatments exist to reduce delirium in patients with dementia. Donepezil improves outcomes during critical illness in patients with dementia. Improved outcomes are mediated by a reduction in hospital delirium. Future studies in patients with dementia should prospectively evaluate donepezil in the prevention of delirium.
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