TY - JOUR T1 - Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 1368 LP - 1374 DO - 10.1136/jnnp-2016-313660 VL - 87 IS - 12 AU - Pinar Soysal AU - Ahmet Turan Isik AU - Brendon Stubbs AU - Marco Solmi AU - Marco Volpe AU - Claudio Luchini AU - Grazia D'Onofrio AU - Alberto Pilotto AU - Enzo Manzato AU - Giuseppe Sergi AU - Patricia Schofield AU - Nicola Veronese Y1 - 2016/12/01 UR - http://jnnp.bmj.com/content/87/12/1368.abstract N2 - We conducted a systematic review and meta-analysis investigating the influence of acetylcholinesterase inhibitors (AChEIs) therapy on nutritional status and weight across observational and interventional studies. Two authors searched major electronic databases from inception until 10/14/2015 for longitudinal, open-label and randomised double-blind placebo controlled (randomised controlled trials (RCTs)) studies of AChEIs in patients with dementia reporting nutritional status outcome data. Out of 3551 initial hits, 25 studies (12 open-label trials, 9 RCTs and 4 longitudinal studies) including 10 792 patients with dementia were meta-analysed. In longitudinal studies (median follow-up 6 months), a significant cumulative incidence of weight loss between baseline and follow-up evaluation was observed (studies=2; 5%; 95% CI 1% to 34%, p<0.0001; I2=95%). These findings were confirmed in open-label trials (6%; 95% CI 4% to 7%, p<0.0001; I2=78%). In 9 RCTs (median follow-up 5 months), those taking AChEIs more frequently experienced weight loss than participants taking placebo (OR=2.18; 95% CI 1.50 to 3.17, p<0.0001; I2=29%). AChEIs therapy contributes to weight loss in patients with dementia, with a 2-fold increased risk observed in the meta-analysis of RCTs. Clinicians should carefully consider the benefit and risk of prescribing AChEIs. Nutritional status should be routinely evaluated in patients with dementia treated with AChEIs. ER -