Comparative analysis of mortality in patients with Alzheimer's disease treated with donepezil or galantamine.
BACKGROUND
few studies have analysed the effect of the long-term use of cholinesterase inhibitors (ChEIs) on mortality.


OBJECTIVE
to compare the long-term effects of galantamine and donepezil treatment on the mortality rate in Alzheimer's disease (AD) patients.


METHODS
a retrospective cohort study.


METHODS
404 patients referred by primary care centres to a Memory Clinic who were diagnosed with probable AD and who were prescribed treatment with donepezil or galantamine.


METHODS
standardised review of the patient's medical records.


RESULTS
14.5% of the patients showed intolerance to the treatment with ChEIs during the first 15 days. Of those patients who initially tolerated the treatment, 18.5% gave it up after a mean duration of 13.36 months and a mean dose of 7.5 mg/day of donepezil or 14.3 mg/day of galantamine. The mean duration of the treatment in patients who did not abandon the treatment was 25.4 months and the mean dose was 8.1 mg/day of donepezil or 20.0 mg/day of galantamine. There were no differences in the mortality rate between patients treated with donepezil or galantamine (13.7 versus 12.2; P = 0.75). The multivariate analysis through binary logistic regression showed that the variables associated with mortality were male gender, older age, heart failure, treatment with antipsychotic drugs and a high score on the Global Deterioration Scale.


CONCLUSIONS
the duration and the dose of donepezil or galantamine are not related to an increase in mortality. The related variables were advanced age, the severity of the dementia, being male, heart failure and treatment with antipsychotic drugs.
López-Pousa
Secundino
S
Research Unit, Institut d'Assistència Sanitaria, C/Dr. Castany s/n, Salt 17190 (Girona), Spain. recerca@ias.scs.es
Olmo
Josep Garre
JG
Franch
Joan Vilalta
JV
Estrada
Antoni Turon
AT
Cors
Olga Soler
OS
Nierga
Imma Pericot
IP
Gelada-Batlle
Esther
E
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality*; D016009:Chi-Square Distribution; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D000077265:Donepezil; D005260:Female; D005702:Galantamine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007189:Indans / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil