Dementia with Lewy bodies is a form of dementia that shares characteristics with both Alzheimer’s and Parkinson’s diseases. However, there is a lack of extensive research on long-term treatment options. A recent study from the Karolinska Institutet in Sweden, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, indicates possible cognitive advantages of treating patients with cholinesterase inhibitors.
Lewy body disease, which encompasses dementia with Lewy bodies (DLB) and Parkinson’s disease (with and without dementia), is the second most prevalent neurodegenerative condition, following Alzheimer’s disease. DLB accounts for around 10-15% of dementia instances and is marked by alterations in sleep patterns, behavior, cognitive abilities, movement, and the autonomic regulation of bodily functions.
“Currently, there are no officially approved therapies for DLB, which leads physicians to often prescribe medications meant for Alzheimer’s, such as cholinesterase inhibitors and memantine, to alleviate symptoms,” states Hong Xu, an assistant professor at the Department of Neurobiology, Care Sciences, and Society at Karolinska Institutet, who is the lead author of this study. “Nevertheless, the effectiveness of these treatments has been uncertain due to mixed trial outcomes and a lack of long-term data.”
In this study, researchers analyzed the long-term impact of cholinesterase inhibitors (ChEIs) and memantine in comparison to having no treatment over a span of up to ten years in a cohort of 1,095 patients diagnosed with DLB. The results demonstrated that ChEIs may help slow cognitive decline over five years, compared to patients receiving memantine or no treatment at all. Additionally, ChEIs were linked to a lower risk of death during the first year following diagnosis.
“Our findings emphasize the potential advantages of ChEIs for individuals with DLB and support the need to update treatment protocols,” remarks Maria Eriksdotter, a professor at the Department of Neurobiology, Care Sciences, and Society at Karolinska Institutet, who is the last author of the study.
It’s important to note that the nature of this study is observational, meaning no conclusions can be drawn about direct cause-and-effect relationships. The researchers did not collect data on patient lifestyle choices, overall health, blood pressure levels, or the presence of Alzheimer’s disease-related pathology, which could have impacted the results. Furthermore, accurately diagnosing DLB remains a complex challenge.
This research was primarily funded by StratNeuro, the Center for Innovative Medicine (CIMED), the KI foundations, and the Swedish Research Council.
