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

Edwin C.K. Tan; Kristina Johnell; Sara Garcia-Ptacek; Miriam L. Haaksma; Johan Fastbom; J. Simon Bell; Maria Eriksdotter

doi:10.1016/j.jalz.2018.02.011

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

Edwin C.K. Tan, Kristina Johnell, Sara Garcia-Ptacek, Miriam L. Haaksma, Johan Fastbom, J. Simon Bell, Maria Eriksdotter

Centre for Medicine Use and Safety

Research output: Contribution to journal › Article › Research › peer-review

44 Citations (Scopus)

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.

Original language	English
Pages (from-to)	944-951
Number of pages	8
Journal	Alzheimer's & Dementia
Volume	14
Issue number	7
DOIs	https://doi.org/10.1016/j.jalz.2018.02.011
Publication status	Published - 2018

Keywords

Alzheimer disease
Cholinesterase inhibitors
Cohort studies
Dementia
Registries
Stroke

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jalz.2018.02.011

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title = "Acetylcholinesterase inhibitors and risk of stroke and death in people with dementia",

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.",

keywords = "Alzheimer disease, Cholinesterase inhibitors, Cohort studies, Dementia, Registries, Stroke",

author = "Tan, {Edwin C.K.} and Kristina Johnell and Sara Garcia-Ptacek and Haaksma, {Miriam L.} and Johan Fastbom and Bell, {J. Simon} and Maria Eriksdotter",

year = "2018",

doi = "10.1016/j.jalz.2018.02.011",

language = "English",

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journal = "Alzheimer's & Dementia",

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T1 - Acetylcholinesterase inhibitors and risk of stroke and death in people with dementia

AU - Tan, Edwin C.K.

AU - Johnell, Kristina

AU - Garcia-Ptacek, Sara

AU - Haaksma, Miriam L.

AU - Fastbom, Johan

AU - Bell, J. Simon

AU - Eriksdotter, Maria

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

KW - Alzheimer disease

KW - Cholinesterase inhibitors

KW - Cohort studies

KW - Dementia

KW - Registries

KW - Stroke

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AN - SCOPUS:85045012331

SN - 1552-5260

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JO - Alzheimer's & Dementia

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ER -

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

Abstract

Keywords

UN SDGs

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