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Slight memory loss: cholinesterase inhibitors offer no proven benefit

In people over 50 presenting moderate memory loss, cholinesterase inhibitors, marketed as a treatment for Alzheimer’s disease, offer no proven benefit in preventing dementia, and cause numerous adverse effects.

Studies have shown that people suffering from slight memory loss are more likely than the general population to end up with dementia. Some firms have tried to use this evidence to recommend cholinesterase inhibitors (approved for the treatment of Alzheimer’s disease) for this section of the population.

In trials to evaluate the effect of cholinesterase inhibitors on the outcome of patients presenting minor, isolated incidents of memory loss more than 4,000 people aged over 50 were given a cholinesterase inhibitor or a placebo over a period of 16 weeks to 4 years. There were no apparent differences in clinical outcome, whereas halting treatment as a result of an adverse effect was more frequent among those being given the cholinesterase inhibitor.

Overall, cholinesterase inhibitors offer no benefits to people aged over 50 with moderate memory loss, but they do have numerous adverse effects. It is better to do without them.

©Prescrire June 2008

Reference: "Anticholinestérasiques sans intérêt dans les troubles légers de la mémoire" Rev Prescrire 2008 ; 28 (296): 455.

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