Cholinesterase inhibitors do not have a role in reducing the risk of dementia developing in patients with mild cognitive impairment, a Cochrane review has concluded.
The review included eight randomised controlled trials involving 5,149 patients with mild cognitive impairment.
Donepezil, galantamine or rivastigmine reduced the risk of a patient developing dementia by 31% at one year compared with patients on placebo, but this was not a significant effect. This dropped to a 16% decrease at three years. There was a 33% decrease in risk at two years, a significant effect, but based on just two studies in the same report.
There was evidence of a significant 9% increase in risk for adverse events in those on cholinesterase inhibitors compared with placebo.
Study lead Dr Tom Russ, clinical research fellow for the Scottish Dementia Clinical Research Network, said there was no basis for prescribing the drugs for patients with memory complaints ‘who do not meet the diagnostic criteria for dementia’.
The Cochrane Library 2012, online 12 September