Dementia with Lewy bodies is a form of dementia that resembles both Alzheimer's disease and Parkinson's disease, but studies on long-term treatments are lacking. A new study from the Karolinska Institutet in Sweden, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, highlights the potential cognitive benefits of treatment with cholinesterase inhibitors.
Lewy body disease, which includes dementia with Lewy bodies (DLB) and Parkinson's disease with and without dementia, is the second most common neurodegenerative disorder after Alzheimer's disease. DLB accounts for about 10-15 percent of dementia cases and is characterized by changes in sleep, behavior, perception, movement, and the control of automatic bodily functions.
“Currently, there are no approved treatments for DLB, so doctors often use medications for Alzheimer's disease, such as cholinesterase inhibitors and memantine, to alleviate symptoms,” says Hong Xu, assistant professor at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and lead author of the study. “However, the effectiveness of these treatments remains uncertain due to inconsistent study results and limited long-term data.”
In the current study, researchers examined the long-term effects of cholinesterase inhibitors (ChEIs) and memantine compared to no treatment over a period of up to ten years in 1,095 patients with DLB. They found that ChEIs, compared to memantine or no treatment, may slow cognitive decline over five years. ChEIs were also associated with a lower risk of death in the first year after diagnosis.
“Our findings highlight the potential benefits of ChEIs for patients with DLB and support the updating of treatment guidelines,” says Maria Eriksdotter, professor at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, and last author of the study.
Since the study is observational, no conclusions about causality can be drawn. The researchers did not have data on patients' lifestyle habits, frailty, blood pressure and Alzheimer's disease co-pathology, which could have influenced the results. Another limitation of the study is that DLB remains difficult to diagnose accurately.
The research was primarily funded by StratNeuro, the Center for Innovative Medicine (CIMED), the KI Foundations, and the Swedish Research Council.
Publication: „Long-Term Effects of Cholinesterase Inhibitors and Memantine on Cognitive Decline, Cardiovascular Events, and Mortality in Dementia with Lewy Bodies: An up to 10-Year Follow-Up Study“, Hong Xu, Annegret Habich, Daniel Ferreira, Londos Elisabet, Eric Westman, Maria Eriksdotter, Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, online 23 August 2024, doi: 10.1002/alz.14118.
