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LETTER TO THE EDITOR |
Columbia University Medical Center New York, New York
Address correspondence to Huai Yong Cheng, MD, MPH, Division of Geriatric Medicine and Aging, The Allen Pavilion, Columbia University Medical Center, 5141 Broadway, New York, NY 10034-1159. E-mail: hyc2105{at}columbia.edu
To the Editor:
Dr. Gillette-Guyonnet and colleagues studied a group of elderly patients with baseline mean Mini-Mental State Examination (MMSE) scores ranging from 15.5 in patients who were not exposed to cholinesterase inhibitors to 21.0 in patients who had three consecutive exposures of cholinesterase inhibitors (1). Their study has shown that patients not treated with cholinesterase inhibitors experienced more rapid cognitive function decline, more frequent institutionalizations, and greater weight loss than those treated with cholinesterase inhibitors (1). This finding is interesting and provides additional evidence to support the potential benefits of giving cholinesterase inhibitors to elderly patients with Alzheimer's disease. However, Alzheimer's patients often have multiple coexisting diseases and take multiple medications including some medications with anticholinergic effects (2). These medications might interact with both the Alzheimer's disease and cholinesterase inhibitors. Coexisting diseases and multiple medications were also associated with institutionalization and weight loss in elderly persons (3–5). Therefore, it would be interesting to see whether the benefit of cholinesterase inhibitor use still holds after adjusting for coexisting diseases and medications (1).
Reference
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