Impact of cholinesterase inhibitors or memantine on survival in adults with Down syndrome and dementia: clinical cohort study. (28th February 2018)

• Record Type: Journal Article
• Authors: Eady, Nicole; Sheehan, Rory; Rantell, Khadija; Sinai, Amanda; Bernal, Jane; Bohnen, Ingrid; Bonell, Simon; Courtenay, Ken; Dodd, Karen; Gazizova, Dina; Hassiotis, Angela; Hillier, Richard; McBrien, Judith; Mukherji, Kamalika; Naeem, Asim; Perez-Achiaga, Natalia; Sharma, Vijaya; Thomas, David; Walker, Zuzana; McCarthy, Jane; Strydom, André
• Is Part Of: British journal of psychiatry. Volume 212:Number 3(2018)
• Page Start: 155
• Page End: 160
• Publication Date: 2018-02-28
• Subjects: Psychiatry -- Periodicals; Psychology, Pathological -- Periodicals; 616.89005
• DOI: 10.1192/bjp.2017.21
• Languages: English
• ISSNs: 0007-1250

Abstract

Abstract : Background: There is little evidence to guide pharmacological treatment in adults with Down syndrome and Alzheimer's disease. Aims: To investigate the effect of cholinesterase inhibitors or memantine on survival and function in adults with Down syndrome and Alzheimer's disease. Method: This was a naturalistic longitudinal follow-up of a clinical cohort of 310 people with Down syndrome diagnosed with Alzheimer's disease collected from specialist community services in England. Results: Median survival time (5.59 years, 95% CI 4.67–6.67) for those on medication ( n = 145, mainly cholinesterase inhibitors) was significantly greater than for those not prescribed medication ( n = 165) (3.45 years, 95% CI 2.91–4.13, log-rank test P <0.001). Sequential assessments demonstrated an early effect in maintaining cognitive function. Conclusions: Cholinesterase inhibitors appear to offer benefit for people with Down syndrome and Alzheimer's disease that is comparable with sporadic Alzheimer's disease; a trial to test the effect of earlier treatment (prodromal Alzheimer's disease) in Down syndrome may be indicated. Declaration of interest: A.S. has undertaken consulting for Ono Pharmaceuticals, outside the submitted work. Z.W. has received a consultancy fee and grant from GE Healthcare, outside the submitted work.