ArticleInternational journal of geriatric psychiatry2026
Long-Term Effect of Acetylcholinesterase Inhibitors on Behavioral and Psychological Symptoms of Dementia.
Article in International journal of geriatric psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Organic Sunscreens-Biological Activity from an Enzymatic Perspective.Molecules (Basel, Switzerland) · 2026Article
- Why acetylcholinesterase inhibitors should be considered disease-modifying drugs for Alzheimer's disease?Aging clinical and experimental research · 2026Review
- Long-Term Effect of Acetylcholinesterase Inhibitors on Behavioral and Psychological Symptoms of Dementia.International journal of geriatric psychiatry · 2026Article
- Effectiveness of Souvenaid® combined with acetylcholinesterase inhibitors on caregiver burden in Alzheimer´s disease.Alzheimer's & dementia (New York, N. Y.)Article
- Memantine, acetylcholinesterase inhibitors, and quality-of-care outcomes among patients with cognitive impairment: an emulated trial design.Alzheimer's & dementia (New York, N. Y.)Article
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Authors and funding
8 authors.
Funding
Abstract
objectiveBehavioral and psychological symptoms of dementia (BPSD) are critical aspects of the clinical presentation of dementia. There is no universally accepted approach for the managment of BPSD, currently based first on a non-pharmacological and subsequently on a pharmacological approach. We explored the potential effect of long-term treatment with acetylcholinesterase inhibitors (AChEI) on BPSD severity over time.
methodsThe initial sample included 4032 older patients with mild-moderate dementia (Alzhemier's disease - AD, Lewy body dementia - LBD, or vascular dementias - VaD) from the National Alzheimer's Coordinating Center Uniform Data Set (NACC UDS). After propensity score matching, a cohort of 1408 patients (704 treated with AChEI = AChEI+ and 704 not treated = AChEI-) was generated. The mean age was 73.2 years (females: 50.4%). The mean follow-up duration was 4.3 ± 1.6 years (range: 2.2-8.3 years). Patients were evaluated at baseline, T1 (2 years), T2 (4 years), T3 (6.2 years), and T4 (8.1 years). BPSD severity was assessed by Neuropsychiatric Inventory (NPI-Q).
resultsThe baseline mean NPI-Q severity score was 1.33. At T4, the score increased to 1.41 in AChEI- patients (+6% from baseline), while it decreased to 1.26 in AChEI+ (-6%) (all p < 0.01 from T1 to T4). As regards the NPI-Q sub-items, six of them (hallucinations, agitation/aggression, depression/dysphoria, anxiety, disinhibition and irritability/lability) exhibited significant differences over time (all p < 0.01) in favor of the AChEI + group (stabilization or improvement). Similar trends were observed when LOAD, LBD and VaD were considered separately. In contrast, for five domains (delusions, elation/euphoria, motor disturbances, night-time behaviors, and appetite/eating changes) no differences were observed.
conclusionsOur study supports the potential role for AChEI in BPSD management, demonstrating a trend toward symptoms stabilization or improvement in patients with mild-moderate dementia. Although the effects were not uniform across all NPI-Q domains, and the limitations of the study, our results reinforces the relevance of AChEI in the comprehensive treatment of dementia.
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