Common Alzheimer's drug appears to slow cognitive decline, helps patients live longer

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SOLNA, Sweden — Cholinesterase inhibitors have been a common treatment for Alzheimer's disease for some time. However, few studies have examined their specific, long-term effects on mental ability. Now, researchers in Sweden report these drugs show “consistent cognitive benefits” up to five years after diagnosis.

A team from Karolinska Institutet adds cholinesterase inhibitors also have a connection to lower death rates among dementia patients. Currently, there are three main cholinesterase inhibitors on the market for Alzheimer's treatment: galantamine, donepezil, and rivastigmine.

When Alzheimer's develops in an individual, various chemical neurotransmitters in the brain undergo detrimental changes. All those changes make it much harder for individual neurons to communicate amongst one another. For instance, one neurotransmitter commonly influenced by Alzheimer's is acetylcholine, which plays a role in memory, concentration, and attention.

Slowing Alzheimer's progression over the long haul

In conjunction with scientists from Umeå University, researchers conducted a registry study consisting of people living with Alzheimer's disease over a course of five years. In all, the team examined data on 11,652 patients treated with a cholinesterase inhibitor. Also, another 5,826 untreated patients served as a control group during the study.

That investigation led researchers to conclude that a dementia treatment plan including cholinesterase inhibitors leads to a slower rate of cognitive decline over five years. Moreover, in comparison to the control group, cholinesterase inhibitors also lower mortality rates by 27 percent.

“Of all three drugs, galantamine had the strongest effect on cognition, which may be due to its effect on nicotine receptors and its inhibiting effect on the enzyme acetylcholinesterase, which breaks down the neurotransmitter acetylcholine,” says Karolinska's Hong Xu, a postdoctoral researcher in the Department of Neurobiology, Care Sciences and Society, in a university release.

“Our results provide strong support for current recommendations to treat people with Alzheimer's disease with cholinesterase inhibitors, but also shows that the therapeutic effect lasts for a long time,” adds study author Maria Eriksdotter, a professor in the same department at the Karolinska Institutet.

The study is published in Neurology.