Dementia and the Impact of Acetylcholinesterase Inhibitors on Falls, Fractures and Mortality in a Geriatric Cohort: A 4-Year Follow-Up Study
Abstract
Objectives: Dementia and osteoporosis are common and debilitating conditions that often coexist in older adults. We investigated mortality in patients with and without dementia as the primary outcome in a prospective memory clinic cohort. Falls and fractures were assessed as secondary outcomes, and associations with baseline acetylcholinesterase inhibitor (AChEI) use were explored. Methods: In a prospective observational cohort study, data were collected during routine clinical visits over four years. Data included demographics, dementia diagnosis, AChEI use, falls, fractures, bone mineral density (BMD) when clinically available, and mortality. Analysis included chi-square tests, Kaplan-Meier survival curves, Cox proportional hazards models, and recurrent-event models. Because AChEI analyses were exploratory and included several related endpoints, Benjamini-Hochberg false discovery rate (FDR) correction was applied to endpoint-level AChEI p-values. Results: 744 patients were enrolled; the mean age was 80.99 ± 6.8 years; 58.5% female; 55.8% with dementia. AChEI use was recorded in 113 patients (15.2%) at baseline. Over 4 years, 16.61% of participants experienced at least one fall with a cumulative fracture risk of 30.90%. Mortality was significantly higher in dementia patients (44.58% vs. 27.05%; p Conclusions: Dementia patients have higher mortality risk but not falls or fracture risk in this cohort. Although clinical cohort and animal studies suggest a benefit for AChEIs,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 744 participants or records.
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