title: Weight Loss Associated with Cholinesterase Inhibitors in Individuals with Dementia in a National Healthcare System.
abstract: OBJECTIVE
  To determine whether initiation of cholinesterase inhibitors is associated with significant weight loss in a real-word clinical setting.
  
  
  METHODS
  Retrospective cohort study from 2007 to 2010 comparing weight loss in individuals with dementia newly prescribed cholinesterase inhibitors and those newly prescribed other chronic medications.
  
  
  METHODS
  National Veterans Affairs data.
  
  
  METHODS
  Individuals aged 65 and older with a diagnosis of dementia who received a new prescription for a cholinesterase inhibitor or other new chronic medication.
  
  
  METHODS
  The primary outcome was time to 10-pound weight loss over 12 months. Propensity score matching was used to control for the likelihood of receiving a cholinesterase inhibitor based on baseline characteristics. Data were analyzed in a priori defined subgroups according to age, comorbid burden, and initial weight.
  
  
  RESULTS
  Of 6,504 individuals that met study criteria, 1,188 started on cholinesterase inhibitors were matched to 2,189 started on other medications. The propensity-matched cohorts were well balanced on baseline covariates. Participants initiated on cholinesterase inhibitors had a higher risk of weight loss than matched controls at 12 months (hazard ratio = 1.23, 95% confidence interval (CI) = 1.07-1.41). At 12 months, 29.3% of participants taking cholinesterase inhibitors had experienced weight loss, compared with 22.8% of nonusers, corresponding to a number needed to harm of 21.2 (95% CI = 12.5-71.4) over 1 year. There were no significant differences in the risk of weight loss within subgroups.
  
  
  CONCLUSIONS
  These results are consistent with the available data from randomized controlled trials. Clinicians should consider the risk of weight loss when prescribing cholinesterase inhibitors.
authors.affiliation: Division of Geriatrics, University of California at San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Meera
authors.initials: M
authors.lastname: Sheffrin
authors.affiliation: Division of Geriatrics, University of California at San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Miao
authors.affiliation: Division of Geriatrics, University of California at San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California.|Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California.
authors.forename: W John
authors.initials: WJ
authors.lastname: Boscardin
authors.affiliation: Division of Geriatrics, University of California at San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Steinman
mesh_terms: D000368:Aged; D001835:Body Weight / Q000187:drug effects; D002800:Cholinesterase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D002800:Cholinesterase Inhibitors
keywords: cholinesterase inhibitors; dementia; weight loss