title: Association between acetylcholinesterase inhibitors and risk of stroke in patients with dementia.
abstract: Patients with dementia are at increased risk of stroke. Acetylcholinesterase inhibitors (AChEIs) have endothelial function protection effects and anti-inflammatory properties. We investigated the ischemic stroke risk in AChEIs use in dementia patients without stroke history. Using Taiwan National Health Insurance Database from 1999 to 2008, 37,352 dementia patients over 50 years old without stroke history were eligible. The results were analyzed by propensity score-matched Cox proportional hazard models with competing risk adjustment. AChEIs users had lower incidence of ischemic stroke (160.3/10,000 person-years), compared to the propensity score-matched reference (240.8/10,000 person-years). The adjusted hazard ratio for ischemic stroke based on propensity score-matched Cox proportional hazard model was 0.508 (95% confidence interval, 0.434-0.594; P < 0.001). There was no significant difference in all-cause mortality between AChEIs users and nonusers. In conclusion, among dementia patients without previous ischemic stroke history, AChEIs treatment was associated with a decreased risk of ischemic stroke but not greater survival.
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Family Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.|Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Lin
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Ping-Hsun
authors.initials: PH
authors.lastname: Wu
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Cheng-Sheng
authors.initials: CS
authors.lastname: Chen
authors.affiliation: School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yi-Hsin
authors.initials: YH
authors.lastname: Yang
authors.affiliation: Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.|Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Yuan-Han
authors.initials: YH
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D020521:Stroke / Q000453:epidemiology*; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology
chemical_list: D002800:Cholinesterase Inhibitors