Who this applies to:
Practitioners prescribing for patients with moderate-to-severe Alzheimer’s disease.
Findings and implications
- Cholinesterase inhibitors were effective for severe Alzheimer’s disease
- These findings are inconsistent with the literature on which NICE guidance was based (due to be updated in 2014) which recommends AChE inhibitors, such as donepezil, for mild to moderate Alzheimer’s disease and memantine for severe disease.
- This study recommends treatment with cholinesterase inhibitor should be considered in the awareness of the increased risks of adverse outcomes including syncope, the need for permanent pacemakers and hip fractures.