Erin L Ferguson, Jingxuan Wang, Justin S White, Katherine Possin, Anna Chodos, Fan Xia, Eva Raphael, Alexander K Smith, M Maria Glymour
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引用次数: 0
Abstract
Introduction: We evaluated the effect of acetylcholinesterase inhibitors (AChEIs) and memantine on non-cognitive outcomes by implementing emulated trials in electronic health records.
Methods: Individuals diagnosed with cognitive impairment who initiated AChEIs or memantine were matched to up to five non-initiators. Associations of medication initiation with 11 non-cognitive outcomes were estimated using Cox proportional hazards models. We calculated e-values for each hazard ratio (HR) and compared their magnitude to socioeconomic predictors of memantine and AChEI use in a US-based cohort.
Results: AChEI initiation was associated with nine of 11 adverse outcomes. For example, the HR for antipsychotic use = 1.67 (95% confidence interval [CI]: 1.51 to 1.84) and depression HR = 1.86 (1.67 to 2.06). Results for memantine were similar. E-values varied from 1.45 to 2.11 for memantine and 1.40 to 2.44 for AChEIs. Many potential confounders had odds ratios (ORs) > 1.4 for initiation, including marital status (ORs = 1.36 to 6.67).
Discussion: Memantine and AChEIs were associated with adverse outcomes, and residual confounding was unlikely to fully account for all the observed associations.
期刊介绍：
Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.
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