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Patterns and predictors of cholinesterase inhibitor use in dementia with Lewy bodies
Rachel J Heo, Ahmed Negida, Kathryn A Wyman-Chick, James R Bateman, Federico Rodriguez-Porcel, Brian D Berman, Nitai Mukhopadhyay, Matthew J Barrett. Alzheimer's & dementia (New York, N. Y.), 2025-07-19
Topic: Drug trials: efficacy and safety
Plain-language summary
We found that 51.9% of DLB patients were ever prescribed a ChEI, and those who were prescribed a ChEI had a greater diagnosis interval. Patients who were prescribed ChEIs were more likely to be Hispanic (odds ratio [OR] 1.36, 95% confidence interval [CI]: 1.15, 1.59) and reside in the Midwest (OR 1.93, 95% CI: 1.76, 2.13), while Black patients were less likely to be prescribed ChEIs (OR 0.80, 95% CI: 0.71, 0.91). Of patients prescribed ChEIs, the median time between the first and last prescription was 13.4 months (interquartile range: 1.1, 32.9), and donepezil was the most commonly prescribed (76.9%) followed by rivastigmine (35.6%) and galantamine (3.9%). Over the 20-year study period, there was a gradual increase in the rate of prescribing of ChEIs, and the prescribing frequency of individual ChEIs remained relatively stable. Despite evidence supporting their tolerability and efficacy, ChEIs are under-prescribed in DLB patients within the United States, and there are differences in prescribing based on race, ethnicity, and region. There is a need to understand the reasons for under-prescribing ChEIs in DLB, so interventions focused on increasing use can be developed. HIGHLIGHTS: Despite proven tolerability and efficacy, cholinesterase inhibitors (ChEIs) are under-prescribed in dementia with Lewy bodies (DLB).Race, ethnicity, and region significantly affected the odds of ChEI prescription.There is a need to increase ChEI prescribing for DLB patients.
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APA 7th
Heo, R. J., Negida, A., Wyman-Chick, K. A., Bateman, J. R., Rodriguez-Porcel, F., Berman, B. D., et al. (2025). Patterns and predictors of cholinesterase inhibitor use in dementia with Lewy bodies. Alzheimer's & dementia (New York, N. Y.). https://doi.org/10.1002/trc2.70136
Vancouver
Heo RJ, Negida A, Wyman-Chick KA, Bateman JR, Rodriguez-Porcel F, Berman BD, et al. Patterns and predictors of cholinesterase inhibitor use in dementia with Lewy bodies. Alzheimer's & dementia (New York, N. Y.). 2025. doi:10.1002/trc2.70136. PMID: 40687401.
BibTeX
@article{heo2025-40687401,
author = {Heo, Rachel J and Negida, Ahmed and Wyman-Chick, Kathryn A and Bateman, James R and Rodriguez-Porcel, Federico and Berman, Brian D and Mukhopadhyay, Nitai and Barrett, Matthew J},
title = {{Patterns and predictors of cholinesterase inhibitor use in dementia with Lewy bodies}},
journal = {Alzheimer's \& dementia (New York, N. Y.)},
year = {2025},
doi = {10.1002/trc2.70136},
pmid = {40687401},
url = {https://doi.org/10.1002/trc2.70136}
}
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 8 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
- We found that 51.9% of DLB patients were ever prescribed a ChEI, and those who were prescribed a ChEI had a greater diagnosis interval.
- Patients who were prescribed ChEIs were more likely to be Hispanic (odds ratio [OR] 1.36, 95% confidence interval [CI]: 1.15, 1.59) and reside in the Midwest (OR 1.93, 95% CI: 1.76, 2.13), while Black patients were less likely to be prescribed ChEIs (OR 0.80, 95% CI: 0.71, 0.91).
- Of patients prescribed ChEIs, the median time between the first and last prescription was 13.4 months (interquartile range: 1.1, 32.9), and donepezil was the most commonly prescribed (76.9%) followed by rivastigmine (35.6%) and galantamine (3.9%).
- Over the 20-year study period, there was a gradual increase in the rate of prescribing of ChEIs, and the prescribing frequency of individual ChEIs remained relatively stable.
- Despite evidence supporting their tolerability and efficacy, ChEIs are under-prescribed in DLB patients within the United States, and there are differences in prescribing based on race, ethnicity, and region.
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Study details
- Effect size51.9%; OR 1.93; OR 0.80
- Evidence strengthLow
How this study scored 52/100
Published in a leading specialty journal. Scored zero for study design, sample size, studied in people and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multicenter collaboration and free to read, so those were left out: it earned 29 of the 56 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia (New York, N. Y.)) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| 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 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40687401) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 29 / 56 | Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 29 of the 56 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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