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Cholinesterase inhibitors for Alzheimer's disease
Birks J.. The Cochrane database of systematic reviews, 2006-01-25
Topic: Amyloid, tau and blood-test diagnosis
Background Since the introduction of the first cholinesterase inhibitor (ChEI) in 1997, most clinicians and probably most patients would consider the cholinergic drugs, donepezil, galantamine and rivastigmine, to be the first line pharmacotherapy for mild to moderate Alzheimer's disease.The drugs have slightly different pharmacological properties, but they all work by inhibiting the breakdown of acetylcholine, an important neurotransmitter associated with memory, by blocking the enzyme acetylcholinesterase. The most that these drugs could achieve is to modify the manifestations of Alzheimer's disease. Cochrane reviews of each ChEI for Alzheimer's disease have been completed (Birks 2005, Birks 2005b and Loy 2005).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Birks, J. (2006). Cholinesterase inhibitors for Alzheimer's disease. The Cochrane database of systematic reviews. https://doi.org/10.1002/14651858.cd005593
Vancouver
Birks J. Cholinesterase inhibitors for Alzheimer's disease. The Cochrane database of systematic reviews. 2006. doi:10.1002/14651858.cd005593. PMID: 16437532.
BibTeX
@article{birks2006-16437532,
author = {Birks, J.},
title = {{Cholinesterase inhibitors for Alzheimer's disease}},
journal = {The Cochrane database of systematic reviews},
year = {2006},
doi = {10.1002/14651858.cd005593},
pmid = {16437532},
url = {https://doi.org/10.1002/14651858.cd005593}
}
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Key findings
- The most that these drugs could achieve is to modify the manifestations of Alzheimer's disease.
- Cochrane reviews of each ChEI for Alzheimer's disease have been completed (Birks 2005, Birks 2005b and Loy 2005).
- Despite the evidence from the clinical studies and the intervening clinical experience the debate on whether ChEIs are effective continues.
- Objectives To assess the effects of donepezil, galantamine and rivastigmine in people with mild, moderate or severe dementia due to Alzheimer's disease.
Why it matters
This review assessed the effects of the cholinesterase inhibitors donepezil, galantamine and rivastigmine in people with mild, moderate or severe dementia due to Alzheimer's disease. It states that the most these drugs could achieve is to modify the manifestations of Alzheimer's disease, and that debate on whether they are effective continues.
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Study details
- Evidence strengthHigh
How this study scored 72/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (The Cochrane database of systematic reviews) |
| Journal's citation record | 3 / 4 | Cochrane Database of Systematic Reviews: journal h-index 468 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies (from PubMed type “Meta-Analysis”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2006 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | A review of other studies — randomization is not credited here |
| Times cited | 7 / 7 | Cited 1,886 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 85.7 citations a year over 22 year(s) since 2006 |
| Impact for its field and year | 6 / 6 | Cited 53.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 63 other studies in this library |
| Still being cited | 3 / 4 | Cited 186 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Jacqueline Birks: h-index 51 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16437532) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 72 / 100 | — |
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