Predictors of Response to Acetylcholinesterase Inhibitors: An Observational Case Register-Based Cohort Study
type: CreativeWork
description: Background: Acetylcholinesterase inhibitors (AChEIs) are a key component of dementia care. Longitudinal cognitive change in patients before and after AChEI initiation has never been described previously, although individual responses have been described as heterogeneous. Predictors of such responses are not well established. This study describes longitudinal cognitive outcomes for patients who received AChEIs at the South London and Maudsley NHS Foundation Trust, UK during 2003 and 2010 in a routine clinical setting. Aims/ Objectives: The primary objective of the study was to describe trajectories of cognitive function, as measured by the MMSE in routine clinical practice in patients who had received AChEI, drawing on data before and after treatment initiation and comparing these slopes. The second objective was to investigate factors associated with cognitive response to AChEI treatment, defined as the difference in MMSE slopes before and after treatment initiation. Methods: A retrospective longitudinal study was constructed of data on 2,460 patients who received AChEIs with minimum of 1 MMSE score within 1 year before drug initiation and at least 1 MMSE score within 3 years after this. Longitudinal MMSE change was modelled using three-piece linear mixed models with the following segments: 0-12 months prior to AChEI initiation, 0-6 months and 6-36 months after initiation. Results: There was a significant improvement in the MMSE trajectory by 4.16 points per year in patients who received AChEIs during the 6 months after treatment compared with the 12 months before treatment. When stratified by MMSE score at AChEI initiation, lower MMSE was found to be associated with a stronger improvement in post- compared to pre-AChEI trajectory. MMSE score trajectories were similar over the 6-36 months after AChEI initiation compared with the 12 months before initiation. However, when stratified by baseline MMSE, patients with highest baseline MMSE had an exaggerated decline over…
abstract: Background: Acetylcholinesterase inhibitors (AChEIs) are a key component of dementia care. Longitudinal cognitive change in patients before and after AChEI initiation has never been described previously, although individual responses have been described as heterogeneous. Predictors of such responses are not well established. This study describes longitudinal cognitive outcomes for patients who received AChEIs at the South London and Maudsley NHS Foundation Trust, UK during 2003 and 2010 in a routine clinical setting. Aims/ Objectives: The primary objective of the study was to describe trajectories of cognitive function, as measured by the MMSE in routine clinical practice in patients who had received AChEI, drawing on data before and after treatment initiation and comparing these slopes. The second objective was to investigate factors associated with cognitive response to AChEI treatment, defined as the difference in MMSE slopes before and after treatment initiation. Methods: A retrospective longitudinal study was constructed of data on 2,460 patients who received AChEIs with minimum of 1 MMSE score within 1 year before drug initiation and at least 1 MMSE score within 3 years after this. Longitudinal MMSE change was modelled using three-piece linear mixed models with the following segments: 0-12 months prior to AChEI initiation, 0-6 months and 6-36 months after initiation. Results: There was a significant improvement in the MMSE trajectory by 4.16 points per year in patients who received AChEIs during the 6 months after treatment compared with the 12 months before treatment. When stratified by MMSE score at AChEI initiation, lower MMSE was found to be associated with a stronger improvement in post- compared to pre-AChEI trajectory. MMSE score trajectories were similar over the 6-36 months after AChEI initiation compared with the 12 months before initiation. However, when stratified by baseline MMSE, patients with highest baseline MMSE had an exaggerated decline over…
author: Perera, Gayan
language: eng
date published: 2013-3
date modified: 2026-07-24T02:44:42Z
provider: King's College London
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: King's College London