title: Caregiver acceptance of adverse effects and use of cholinesterase inhibitors in Alzheimer's disease.
abstract: Caregivers play a determining role in choosing treatments for persons with Alzheimer's disease. The objective of this study was to examine caregivers' willingness to have persons with Alzheimer's disease continue taking cholinesterase inhibitors in the event that any 1 of 11 adverse effects was to occur. Data were gathered via postal questionnaire from 375 caregivers in Montreal. Sixty-four per cent of caregivers responded ( n = 201), and most (> or =59%) were willing to continue treatment if persons with Alzheimer's disease suffered from weight loss or loss of appetite. However, most (> or =53%) were not willing to continue treatment in the event of headache, dizziness, nausea, diarrhea, vomiting, drop in blood pressure, insomnia, muscle cramps, or stomach bleeding. The use of cholinesterase inhibitors by persons with Alzheimer's disease was positively associated with caregivers' willingness to accept greater numbers of adverse effects (adjusted relative risk = 1.97; 95% CI = 1.11 to 3.61). Caregivers appear to make a risk-benefit assessment when they decide whether or not care-recipients should continue pharmacotherapy in the event of adverse effects.
authors.affiliation: Centre for Clinical Epidemiology and Community Studies, S.M.B.D. Jewish General Hospital, Montreal. oremusm@mcmaster.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Oremus
authors.forename: Christina
authors.initials: C
authors.lastname: Wolfson
authors.forename: Alain C
authors.initials: AC
authors.lastname: Vandal
authors.forename: Howard
authors.initials: H
authors.lastname: Bergman
authors.forename: Qihao
authors.initials: Q
authors.lastname: Xie
mesh_terms: D000375:Aging; D000544:Alzheimer Disease / Q000188:drug therapy*; D001066:Appetite; D017028:Caregivers / Q000523:psychology*; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011792:Quebec; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D015431:Weight Loss
chemical_list: D002800:Cholinesterase Inhibitors