Patterns of use and adverse events associated with cholinesterase inhibitors in older adults with dementia.
Published: 2004
Language: eng
Number of pages: 111
Description: Cholinesterase inhibitors have been widely adopted to manage the symptoms of Alzheimer's disease and related dementias. Cholinesterase inhibitors can precipitate urinary incontinence, but this adverse drug effect may go undetected because incontinence is also seen in the natural progression of dementia. This thesis documents a possible prescribing cascade, in which the use of cholinesterase inhibitors leads to the dispensation of anticholinergic drugs to manage incontinence. This prescribing cascade is important, as anticholinergic drugs may exacerbate cognitive decline in patients with dementia. In a population-based cohort study of older adults with dementia, those who were dispensed cholinesterase inhibitors were found to have a higher risk of subsequently receiving an anticholinergic drug (4.5% vs. 3.1%, p &lt; 0.001; hazard ratio 1.55, 95% confidence interval 1.39--1.72). This finding was consistent in a series of subgroup analyses. Clinicians should consider the potential risks of co-prescribing cholinesterase inhibitors and anticholinergic drugs to patients with dementia.
Notes: Adviser:  Paula A. Rochon.

Thesis (M.Sc.)--University of Toronto, 2004.

Electronic version licensed for access by U. of T. users.

Source: Masters Abstracts International, Volume: 42-06, page: 2153.

MICR copy on microfiche (2 microfiches).