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Cholinesterase inhibitors and memantine are associated with a reduced mortality in nursing home residents with dementia: a longitudinal observational study
Havreng-Théry C, Oquendo B, Zolnowski-Kolp V, Krolak-Salmon P, Bertin-Hugault F, Lafuente-Lafuente C, Belmin J. Alzheimer's Research & Therapy, 2024-05-29
Topic: Risk, prevention and care in population studies
Plain-language summary
Background A large proportion of nursing home (NH) residents suffer from dementia and effects of conventional anti-dementia drugs on their health is poorly known. We aimed to investigate the associations between exposure to anti-dementia drugs and mortality among NH residents. Methods This retrospective longitudinal observational study involved 329 French NH and the residents admitted in these facilities since 2014 and having major neurocognitive disorder. From their electronic health records, we obtained their age, sex, level of dependency, Charlson comorbidity index, and Mini mental examination score at admission. Exposure to anti-dementia drugs was determined using their prescription into 4 categories: none, exposure to acetylcholinesterase inhibitors (AChEI) alone, exposure to memantine alone, exposure to AChEI and memantine. Survival until the end of 2019 was studied in the entire cohort by Cox proportional hazards. To alleviate bias related to prescription of anti-dementia drugs, we formed propensity-score matched cohorts for each type of anti-dementia drug exposure, and studied survival by the same method. Results We studied 25,358 NH residents with major neurocognitive disorder. Their age at admission was 87.1 + 7.1 years and 69.8% of them were women. Exposure to anti-dementia drugs occurred in 2,550 (10.1%) for AChEI alone, in 2,055 (8.1%) for memantine alone, in 460 (0.2%) for AChEI plus memantine, whereas 20,293 (80.0%) had no exposure to anti-dementia drugs. Adjusted hazard ratios for mortality were significantly reduced for these three groups exposed to anti-dementia drugs, as compared to reference group: HR: 0.826, 95%CI 0.769 to 0.888 for AChEI; 0.857, 95%CI 0.795 to 0.923 for memantine; 0.742, 95%CI 0.640 to 0.861 for AChEI plus memantine. Results were consistent in propensity-score matched cohorts. Conclusion The use of conventional anti-dementia drugs is associated with a lower mortality in nursing home residents with dementia and should be widely used in this population.
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APA 7th
Havreng-Théry, C., Oquendo, B., Zolnowski-Kolp, V., Krolak-Salmon, P., Bertin-Hugault, F., Lafuente-Lafuente, C., et al. (2024). Cholinesterase inhibitors and memantine are associated with a reduced mortality in nursing home residents with dementia: a longitudinal observational study. Alzheimer's Research & Therapy. https://doi.org/10.1186/s13195-024-01481-0
Vancouver
Havreng-Théry C, Oquendo B, Zolnowski-Kolp V, Krolak-Salmon P, Bertin-Hugault F, Lafuente-Lafuente C, et al. Cholinesterase inhibitors and memantine are associated with a reduced mortality in nursing home residents with dementia: a longitudinal observational study. Alzheimer's Research & Therapy. 2024. doi:10.1186/s13195-024-01481-0. PMID: 38812028.
BibTeX
@article{havrengthery2024-38812028,
author = {Havreng-Théry, C. and Oquendo, B. and Zolnowski-Kolp, V. and Krolak-Salmon, P. and Bertin-Hugault, F. and Lafuente-Lafuente, C. and Belmin, J.},
title = {{Cholinesterase inhibitors and memantine are associated with a reduced mortality in nursing home residents with dementia: a longitudinal observational study}},
journal = {Alzheimer's Research \& Therapy},
year = {2024},
doi = {10.1186/s13195-024-01481-0},
pmid = {38812028},
url = {https://doi.org/10.1186/s13195-024-01481-0}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results We studied 25,358 NH residents with major neurocognitive disorder.
- Adjusted hazard ratios for mortality were significantly reduced for these three groups exposed to anti-dementia drugs, as compared to reference group: HR: 0.826, 95%CI 0.769 to 0.888 for AChEI; 0.857, 95%CI 0.795 to 0.923 for memantine; 0.742, 95%CI 0.640 to 0.861 for AChEI plus memantine.
- Results were consistent in propensity-score matched cohorts.
- Conclusion The use of conventional anti-dementia drugs is associated with a lower mortality in nursing home residents with dementia and should be widely used in this population.
Why it matters
This observational study found that use of cholinesterase inhibitors and memantine was associated with reduced mortality in nursing home residents with dementia. The results were consistent in propensity-score matched cohorts.
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Study details
- Study designcohort
- Participants25,358
- Effect sizeMortality HR 0.83 (95% CI 0.77-0.89) for cholinesterase inhibitors; 0.86 (0.80-0.92) for memantine; 0.74 (0.64-0.86) for both
- Evidence strengthModerate
Limitations
Observational; healthier residents may be more likely to be prescribed these drugs (healthy-user bias) despite matching; French care-home population; cause of death not analysed.
How this study scored 61/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomized / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 60 of the 98 points we could judge it on, which is 61 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer's Research & Therapy) |
| Journal's citation record | 1 / 4 | Alzheimer s Research & Therapy: journal h-index 146 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 25,358 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 15 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.8 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 3 / 6 | Cited 4.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Joël Belmin: h-index 44 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Sorbonne Université: institution h-index 895 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 38812028) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 60 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 60 of the 98 points we could judge it on is 61 out of 100. |
| Total | 61 / 100 | — |
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