A recent study by researchers at the Karolinska Institutet in Sweden has found that cholinesterase inhibitors, commonly used Alzheimer’s disease medications, may help slow down cognitive decline in individuals with dementia with Lewy bodies over a five-year period. Dementia with Lewy bodies is the second most common type of dementia, characterized by protein clumps called Lewy bodies in the brain. People with this type of dementia experience symptoms similar to Alzheimer’s disease and Parkinson’s disease, such as memory loss, cognitive issues, and movement concerns.
The study, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, analyzed data from over 1,000 individuals diagnosed with dementia with Lewy bodies from the Swedish Registry on cognitive/dementia disorders. Participants were prescribed either donepezil, a cholinesterase inhibitor, memantine, or no treatment at all, within three months of diagnosis, and were followed for up to 10 years. The researchers found that the use of cholinesterase inhibitors significantly slowed cognitive decline over the five-year study period compared to those prescribed memantine or no treatment.
Cholinesterase inhibitors work by preventing the breakdown of acetylcholine, a neurochemical important for memory and thinking skills, in nerve cells. Memantine, on the other hand, is prescribed to treat memory loss by blocking the effects of excess glutamate that negatively impacts nerve cells in Alzheimer’s disease. The study’s findings suggest that cholinesterase inhibitors may be beneficial for individuals with dementia with Lewy bodies, providing relief from symptoms and potentially reducing mortality risk in the first year after diagnosis.
Clinical experts in the field, such as Karen D. Sullivan and David Merrill, have noted that cholinesterase inhibitors are often prescribed off-label for individuals with Lewy body dementia due to the lack of FDA-approved medications for this condition. Sullivan, a Reid Healthcare Transformation Fellow, highlighted the significance of these findings in supporting the use of cholinesterase inhibitors for patients with dementia with Lewy bodies who may benefit from symptom relief. Merrill, a board-certified geriatric psychiatrist, emphasized the importance of spreading awareness about the potential benefits of these medications for individuals with Lewy body dementia.
Moving forward, further research is needed to explore the clinical benefits of cholinesterase inhibitors in other populations, as well as to investigate potential lifestyle factors that may contribute to cognitive improvement in individuals with dementia with Lewy bodies. With the prevalence of Lewy body dementia and the current lack of FDA-approved treatments, continued research and understanding of the effectiveness of existing medications are crucial in providing better management and care for individuals with this challenging condition.
