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Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data

Authors
 Minjae Kang  ;  Dan Bee Lee  ;  Sungchan Kwon  ;  Eun Lee  ;  Woo Jung Kim 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.11(16) : 4661, 2022-08 
Journal Title
JOURNAL OF CLINICAL MEDICINE
Issue Date
2022-08
Keywords
Alzheimer disease ; cholinesterase inhibitors ; cognitive dysfunction ; dementia ; mental status and dementia test ; nootropic agents
Abstract
The clinical benefits of nootropics in the treatment of cognitive decline has been either limited or controversial. This study aimed to observe the effectiveness of cholinesterase inhibitor (ChEI) and nootropics combination in the treatment of cognitive impairment in dementia. Data were based on electronic medical records in a university health system. Patients with mild-to-moderate dementia and no history of prior cognitive enhancer use were included (n = 583). The subjects were categorized into the ChEI only group and the ChEI and nootropics combination group. The primary outcome measure was the change in cognitive function, as assessed by the mini-mental state examination (MMSE) from baseline to 300-400 days after the first ChEI prescription. Subsequent analyses were conducted in consideration of the dementia type, medical adherence, and type of nootropics. The changes in MMSE scores from baseline to endpoint were not significantly different between the two groups. In Alzheimer's dementia, the combination group showed significantly less deterioration in MMSE language subscale scores compared to the ChEI only group (F = 6.86, p = 0.009), and the difference was consistent in the highly adherent subjects (F = 10.16, p = 0.002). The choline alfoscerate and the ginkgo biloba extract subgroups in Alzheimer's dementia showed more significant improvements in the MMSE language subscale scores compared to the other nootropics subgroup (F = 7.04, p = 0.001). The present study showed that the effectiveness of ChEI and nootropics combination on cognition may appear differently according to the dementia type. This emphasizes the need for well-controlled studies to generalize the effectiveness of nootropics across various clinical settings.
Files in This Item:
T202203363.pdf Download
DOI
10.3390/jcm11164661
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Woo Jung(김우정) ORCID logo https://orcid.org/0000-0002-4963-4819
Lee, Eun(이은) ORCID logo https://orcid.org/0000-0002-7462-0144
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191852
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