Acetylcholinesterase inhibitors and risk of stroke and death in people with dementia. Issue 7 (26th April 2018) - Tan, Edwin C.K.
Abstract: Introduction: The aim of this study was to investigate the association between acetylcholinesterase inhibitor (AChEI) use and risk of ischemic stroke and death in people with dementia. Methods: A cohort study of 44, 288 people with dementia registered in the Swedish Dementia Registry from 2007 to 2014. Propensity score‐matched competing risk regression models were used to compute hazard ratios and 95% confidence intervals for the association between time‐dependent AChEI use and risk of stroke and death. Results: Compared with matched controls, AChEI users had a lower risk of stroke (hazard ratio: 0.85, 95% confidence interval: 0.75–0.95) and all‐cause death (hazard ratio: 0.76, 95% confidence interval: 0.72–0.80). After considering competing risk of death, high doses (≥1.33 defined daily doses) of AChEI remained significantly associated with reduced stroke risk. Discussion: The use of AChEIs in people with dementia may be associated with reduced risk of ischemic stroke and death. These results call for a closer examination of the cardiovascular effects of AChEIs.