Abstract
Alzheimer’s disease (AD) is the most common form of dementia over the age of 65. It is estimated that 115.4 million people will be affected by AD by 2050. Acetylcholinesterase inhibitors (AChEI) are the only available and approved treatment for AD. The aim of the present study was to analyse the evidence on the efficacy of the AChEI in the treatment of cognitive symptoms of Alzheimer’s disease. For that purpose, a review of review of the systematic reviews (SRs) on this topic was carried out by Web of Science, PubMed, and The Cochrane Library, among others, were searched until 24 September 2021. Thirteen of the 1773 articles evaluated the efficacy of AChEI on cognitive function and/or general condition and/or behavioural disturbances of patients with mild to moderate AD. Methodological quality and risk of bias were rated using the ROBIS scale. The quality of the identified studies was high for nine of them, unclear for two, and finally only in two of the 13 studies did we detect low quality. Overall, AChEI showed very low efficacy in improving cognition in patients with mild to moderate AD. Better results were obtained in improving global state, with donepezil being the most effective treatment. No improvements in behavioural disturbances were found. Few high-quality reviews provide clear evidence of the effects of AChEI on cognition, global change, behaviour, and mortality. The data suggest that AChEI stabilize or slow cognitive deterioration, improving global status. In addition, data indicate that the use of AChEI decreases mortality in patients with mild to moderate AD. However, there is no evidence that they improve patient behaviour. Donepezil is the best therapeutic alternative at a dose of 10 mg/day.
Highlights
Alzheimer’s disease (AD) is the most common cause of dementia in people over 65 years of age and there is no effective treatment to date
After removing the duplicates [16], 1773 studies were suitable for review and by reading the title and abstract 121 publications were considered candidates for analysis in accordance with the previously established inclusion criteria
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Summary
Alzheimer’s disease (AD) is the most common cause of dementia in people over 65 years of age and there is no effective treatment to date. Health Organization as a neurodegenerative disease of unknown etiology characterized by a progressive deterioration of memory and cognitive function [1]. It affects about 10% of people over 65 years of age [2], being more prevalent in women [3]. AD is characterized by a prolonged duration, which makes it difficult to identify the factors associated with the onset of the pathology. In this regard, only 1–5% of cases have a known origin, with the origin of the disease being exclusively attributed to genetic or hereditary factors
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