| Title |
Cholinesterase Inhibitors for Treatment of Psychotic Symptoms in Alzheimer Disease and Parkinson Disease
|
|---|---|
| Published in |
JAMA Neurology, August 2023
|
| DOI | 10.1001/jamaneurol.2023.1835 |
| Pubmed ID | |
| Authors |
Emile d’Angremont, Marieke J. H. Begemann, Teus van Laar, Iris E. C. Sommer |
| Abstract |
Psychotic symptoms greatly increase the burden of disease for people with neurodegenerative disorders and their caregivers. Cholinesterase inhibitors (ChEIs) may be effective treatment for psychotic symptoms in these disorders. Previous trials only evaluated neuropsychiatric symptoms as a secondary and an overall outcome, potentially blurring the outcomes noted with ChEI use specifically for psychotic symptoms. To quantitatively assess the use of ChEIs for treatment of individual neuropsychiatric symptoms, specifically hallucinations and delusions, in patients with Alzheimer disease (AD), Parkinson disease (PD), and dementia with Lewy bodies (DLB). A systematic search was performed in PubMed (MEDLINE), Embase, and PsychInfo, without year restrictions. Additional eligible studies were retrieved from reference lists. The final search cutoff date was April 21, 2022. Studies were selected if they presented the results of placebo-controlled randomized clinical trials, including at least 1 donepezil, rivastigmine, or galantamine treatment arm in patients with AD, PD, or DLB; if they applied at least 1 neuropsychiatric measure including hallucinations and/or delusions; and if a full-text version of the study was available in the English language. Study selection was performed and checked by multiple reviewers. Original research data were requested on eligible studies. A 2-stage meta-analysis was then performed, using random-effects models. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed for extracting data and assessing the data quality and validity. Data extraction was checked by a second reviewer. Primary outcomes were hallucinations and delusions; secondary outcomes included all other individual neuropsychiatric subdomains as well as the total neuropsychiatric score. In total, 34 eligible randomized clinical trials were selected. Individual participant data on 6649 individuals (3830 [62.6%] women; mean [SD] age, 75.0 [8.2] years) were obtained from 17 trials (AD: n = 12; PD: n = 5; individual participant data were not available for DLB). An association with ChEI treatment was shown in the AD subgroup for delusions (-0.08; 95% CI, -0.14 to -0.03; P = .006) and hallucinations (-0.09; 95% CI, -0.14 to -0.04; P = .003) and in the PD subgroup for delusions (-0.14; 95% CI, -0.26 to -0.01; P = .04) and hallucinations (-0.08, 95% CI -0.13 to -0.03; P = .01). The results of this individual participant data meta-analysis suggest that ChEI treatment improves psychotic symptoms in patients with AD and PD with small effect sizes. |
X Demographics
The data shown below were collected from the profiles of 112 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 11 | 10% |
| Spain | 11 | 10% |
| United States | 10 | 9% |
| Japan | 6 | 5% |
| Canada | 3 | 3% |
| France | 3 | 3% |
| Chile | 2 | 2% |
| Finland | 2 | 2% |
| Brazil | 2 | 2% |
| Other | 14 | 13% |
| Unknown | 48 | 43% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 68 | 61% |
| Practitioners (doctors, other healthcare professionals) | 23 | 21% |
| Scientists | 20 | 18% |
| Science communicators (journalists, bloggers, editors) | 1 | <1% |
Mendeley readers
The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 40 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 8 | 20% |
| Other | 6 | 15% |
| Unspecified | 4 | 10% |
| Student > Doctoral Student | 3 | 8% |
| Student > Master | 3 | 8% |
| Other | 9 | 23% |
| Unknown | 7 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 25% |
| Neuroscience | 4 | 10% |
| Unspecified | 4 | 10% |
| Nursing and Health Professions | 3 | 8% |
| Computer Science | 2 | 5% |
| Other | 8 | 20% |
| Unknown | 9 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 82. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 December 2023.
All research outputs
#531,056
of 25,708,267 outputs
Outputs from JAMA Neurology
#701
of 5,892 outputs
Outputs of similar age
#9,896
of 358,891 outputs
Outputs of similar age from JAMA Neurology
#28
of 59 outputs
Altmetric has tracked 25,708,267 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,892 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 44.3. This one has done well, scoring higher than 88% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 358,891 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 59 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 52% of its contemporaries.