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Cholinesterase inhibitors for mild cognitive impairment
Russ TC, Morling JR.. The Cochrane database of systematic reviews, 2012-09-12
Topic: Risk, prevention and care in population studies
Main results Nine studies (from eight published reports) of 5149 individuals with mild cognitive impairment (however defined) were included in the review. Limited pooling of results was possible owing to different lengths of trials. The risk ratio (RR) for conversion at two years was significantly different from unity (0.67; 95% confidence interval (CI) 0.55 to 0.83), but this is based on only two studies reported in the same article. There was essentially no effect of cholinesterase inhibitors on cognitive test scores.Based on the results from 4207 individuals, there were significantly more adverse events in the cholinesterase inhibitor groups (RR 1.09; 95% CI 1.02 to 1.16), but no more serious adverse events or deaths. Other side effects reported significantly more often in the cholinesterase inhibitor group were muscle spasms/leg cramps (RR 7.52; 95% CI 4.34 to 13.02), headache (RR 1.34; 95% CI 1.05 to 1.71), syncope or dizziness (RR 1.62; 95% CI 1.36 to 1.93), insomnia (RR 1.66; 95% CI 1.36 to 2.02) and abnormal dreams (RR 4.25; 95% CI 2.57 to 7.04). This weak evidence is overwhelmed by the increased risk of adverse events, particularly gastrointestinal.
Key findings
- Main results Nine studies (from eight published reports) of 5149 individuals with mild cognitive impairment (however defined) were included in the review.
- Limited pooling of results was possible owing to different lengths of trials.
- The risk ratio (RR) for conversion at two years was significantly different from unity (0.67; 95% confidence interval (CI) 0.55 to 0.83), but this is based on only two studies reported in the same article.
- There was essentially no effect of cholinesterase inhibitors on cognitive test scores.Based on the results from 4207 individuals, there were significantly more adverse events in the cholinesterase inhibitor groups (RR 1.09; 95% CI 1.02 to 1.16), but no more serious adverse events or deaths.
- Other side effects reported significantly more often in the cholinesterase inhibitor group were muscle spasms/leg cramps (RR 7.52; 95% CI 4.34 to 13.02), headache (RR 1.34; 95% CI 1.05 to 1.71), syncope or dizziness (RR 1.62; 95% CI 1.36 to 1.93), insomnia (RR 1.66; 95% CI 1.36 to 2.02) and abnormal dreams (RR 4.25; 95% CI 2.57 to 7.04).
Why it matters
This review of nine studies found cholinesterase inhibitors had essentially no effect on cognitive test scores in people with mild cognitive impairment and were linked to significantly more adverse events. The weak evidence of reduced conversion was outweighed by the increased risk of side effects.
Study details
- Study designmeta-analysis
- Participants5,149
- Effect sizeRR 1.09; RR 2.10; RR 2.97
- Evidence strengthHigh
How this study scored 72/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies.
| 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 |
| 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 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 5,149 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) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 168 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.5 citations a year over 16 year(s) since 2012 |
| Impact for its field and year | 4 / 6 | Cited 8.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 13 other studies in this library |
| Still being cited | 2 / 4 | Cited 21 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Joanne R Morling: h-index 31 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Edinburgh: institution h-index 1,378 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 22972133) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 72 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1002/14651858.cd009132.pub2
- PubMed: 22972133
- Original source →
- Free full text: Cochrane Database of Systematic Reviews →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Russ, T. C., & Morling, JR. (2012). Cholinesterase inhibitors for mild cognitive impairment. The Cochrane database of systematic reviews. https://doi.org/10.1002/14651858.cd009132.pub2
Vancouver
Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. The Cochrane database of systematic reviews. 2012. doi:10.1002/14651858.cd009132.pub2. PMID: 22972133.
BibTeX
@article{russ2012-22972133,
author = {Russ, T. C. and Morling, JR.},
title = {{Cholinesterase inhibitors for mild cognitive impairment}},
journal = {The Cochrane database of systematic reviews},
year = {2012},
doi = {10.1002/14651858.cd009132.pub2},
pmid = {22972133},
url = {https://doi.org/10.1002/14651858.cd009132.pub2}
}
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