Abstract
Cholinesterase inhibitors (ChEIs) such as donepezil have the effect of delaying progression of Alzheimer's disease (AD) or Dementia with Lewy Bodies (DLB). We previously reported (BMC Neurol 2014) the positive effect on life expectancy of AD patients, however, that of DLB is unclear. We analyzed the influence of donepezil on life expectancy after onset of DLB.reported (BMC Neurol 2014) the positive effect on life expectancy of AD patients, however, that of DLB is unclear. We analyzed the influence of donepezil on life expectancy after onset of DLB. All outpatients at the Tajiri Clinic from 1999–2012 with available medical records and death certificates were included in a retrospective analysis. The entry criteria were a dementia diagnosis based on DSM-IV criteria and diagnosis of DLB using the consensus criteria; medical treatment for more than 3 months; and follow up until less than 1 year before death. We identified 390 subjects with medical records and death certificates, of whom 275 had a diagnosis of dementia that met the entry criteria. Of 39 patients diagnosed with DLB, 11 had taken donepezil and 28 patients had not received the drug due to treatment prior to the introduction of donepezil in 1999 in Japan. The lifetime expectancies after onset were 6.4 years in the donepezil group and 3.6 years in the non-donepezil group. There were covariate effect of Parkinsonism and nursing home (NH) residency; however, the latter was cancelled by 4-group (donepezil/NH, yes/no) analysis. Although this report has the limitation of all retrospective analyses: the lack of randomization, we found a positive effect of donepezil on lifetime expectancy after onset of DLB. This may be due to a decreased mortality rate caused by reduction of concomitant diseases. The lesser effect of NH residency compared to AD suggests a greater importance of drug treatment for DLB patients.
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