Acetylcholinesterase inhibitors and risk of stroke and death in people with dementia

Author(s):
Tan, E.C.K.; Johnell, K.; Garcia-Ptacek, S.; Haaksma, M.L. (0000-0002-3518-9152); Fastbom, J.; Bell, J.S.; Eriksdotter, M.
Published
2018
Publication type
Article / Letter to editor

Abstract

Introduction: The aim of this study was to investigate the association between acetylcholinesterase inhibitor (AChEI) use and risk of ischemic stroke and death in people with dementia.Methods: A cohort study of 44,288 people with dementia registered in the Swedish Dementia Registry from 2007 to 2014. Propensity score-matched competing risk regression models were used to compute hazard ratios and 95% confidence intervals for the association between time-dependent AChEI use and risk of stroke and death.Results: Compared with matched controls, AChEI users had a lower risk of stroke (hazard ratio: 0.85, 95% confidence interval: 0.75-0.95) and all-cause death (hazard ratio: 0.76, 95% confidence interval: 0.72-0.80). After considering competing risk of death, high doses (>= 1.33 defined daily doses) of AChEI remained significantly associated with reduced stroke risk.Discussion: The use of AChEIs in people with dementia may be associated with reduced risk of ischemic stroke and death. These results call for a closer examination of the cardiovascular effects of AChEIs. (C) 2018 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Cholinesterase inhibitorsStrokeDementiaAlzheimer diseaseCohort studiesRegistries
Date issued
2018-07-01
Language
English
Publisher
ELSEVIER SCIENCE INC
Is part of
Alzheimer's & Dementia: The Journal of the Alzheimer's Association (2018), Vol. 14, no. 7, p. 944-951
hdl
1887/4105048
doi
10.1016/j.jalz.2018.02.011