title: Cholinesterase inhibitors for Alzheimer disease: do they provide more than symptomatic benefits?
abstract: OBJECTIVE
  This study aims to examine survival of patients with Alzheimer disease (AD) receiving clinical efficacy of cholinesterase inhibitors (ChEIs) and to compare their survival with those of patients with AD who never received ChEIs and cognitively intact old psychiatric outpatients.
  
  
  METHODS
  The retrospective cohort study used national mortality data provided by the Korean National Statistics Office and electronic database of 15 general hospitals on older patients who began outpatient treatment with psychiatric medications including ChEIs (N = 3,813). The authors controlled for confounding by using multivariate models and propensity scoring methods.
  
  
  METHODS
  Mortality rate of patients with AD receiving ChEIs was compared with those of patients with AD who never received ChEIs and cognitively intact old psychiatric outpatients.
  
  
  RESULTS
  Observed additional survival of patients with AD receiving ChEIs (mortality rate: 13.1%), when compared with patients with AD who never received ChEIs (15.4%) was not statistically significant (p = 0.74; hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 0.67-1.59). Patients with AD receiving ChEIs showed higher mortality rate (13.1%) compared with that of cognitively intact old psychiatric outpatients (8.6%) (p <0.001; HR: 1.60, 95% CI: 0.96-2.68).
  
  
  CONCLUSIONS
  This study does not support that ChEIs increase survival of patients with AD, compared with patients with AD who have never treated with ChEIs. Therefore, all ChEIs should be considered for symptomatic use only and not to be capable of modifying mortality of patients with AD.
authors.affiliation: Department of Psychiatry, Hallym University Medical Center, Hangang Sacred Heart Hospital, Seoul, Korea. suhgh@chol.com
authors.forename: Guk-Hee
authors.initials: GH
authors.lastname: Suh
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Ryu
authors.forename: Dong-Woo
authors.initials: DW
authors.lastname: Lee
authors.forename: Changsu
authors.initials: C
authors.lastname: Han
authors.forename: Young-Su
authors.initials: YS
authors.lastname: Ju
authors.forename: Baik Seok
authors.initials: BS
authors.lastname: Kee
authors.forename: Joon-Noh
authors.initials: JN
authors.lastname: Lee
authors.forename: Jae Nam
authors.initials: JN
authors.lastname: Bae
authors.forename: Jong-Hyuk
authors.initials: JH
authors.lastname: Choi
authors.forename: Dai-Jin
authors.initials: DJ
authors.lastname: Kim
authors.forename: Nam-Jin
authors.initials: NJ
authors.lastname: Lee
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Hyo-Jin
authors.initials: HJ
authors.lastname: Go
authors.forename: Jung-Seo
authors.initials: JS
authors.lastname: Yi
authors.forename: Seong-Jin
authors.initials: SJ
authors.lastname: Cho
authors.forename: Yang-Whan
authors.initials: YW
authors.lastname: Jeon
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000401:mortality; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies
chemical_list: D002800:Cholinesterase Inhibitors