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medications could cause harmful weight loss
Medications commonly used to treat dementia could result
in harmful weight loss, according to researchers, and
clinicians need to account for this risk when prescribing
these drugs to older adults, they said.
"This is very relevant to patient care because
unintentional weight loss in older adults is associated
with many adverse outcomes, including increased rates of
institutionalization and mortality, a decline in
functional status, and poorer quality of life," said lead
author Meera Sheffrin, MD, geriatrics fellow in the UCSF
School of Medicine at the UCSF-affiliated San Francisco VA
Medical Center. "Our study provides evidence in a large,
real-world population that cholinesterase inhibitors
may contribute to clinically significant weight loss in a
substantial proportion of older adults with dementia."
Alzheimer's disease and other dementias are
prevalent, affecting one in six people over age 80. The
main drug treatments, a class of medications called
cholinesterase inhibitors, are marginally beneficial for
most patients and may have serious side effects such as gastrointestinal
Further research is needed to validate these findings and
address study limitations, including if there is a
specific subgroup in which starting cholinesterase
inhibitors had a higher risk of weight loss, as this study
may have been underpowered to find those differences. The
sample also included mainly older male veterans, so the
generalizability of the findings to women is uncertain,
the researchers said.
"Clinicians should take into account the risk of weight
loss when weighing the risks and benefits of prescribing
cholinesterase inhibitors in patients with dementia,"
the authors write. "In addition, clinicians should monitor
for weight loss if these medications are prescribed and
consider discontinuing cholinesterase inhibitors if
significant weight loss occurs."
Other UCSF contributors
to the Journal of the American Geriatrics Society study
were senior author Mike Steinman, MD, associate professor,
and Yinghui Miao, MD, MPH, statistician, of geriatrics;
and W. John Boscardin, PhD, professor of epidemiology and
biostatistics. University of Claifornia San Francisco.
Journal of the American Geriatrics Society