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Linear mixed\u2010effects models assessed cognitive trajectories. Locally estimated scatterplot smoothing regression analyzed cognitive changes before and after ChEI initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Among 558 amnestic MCI participants (168 ChEI users), ChEI users exhibited higher risk of progression to AD dementia (hazard ratio\u00a0=\u00a01.77, 95% confidence interval: 1.15 to 2.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001). Both ChEI use and A\u03b2 burden independently accelerated MCI progression and cognitive decline. Cognitive trajectories demonstrated decline before ChEI initiation and continued to decline after treatment began.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>The association between ChEI treatment and accelerated progression to AD dementia and cognitive decline, independent of A\u03b2 status, emphasized the need to reconsider optimal timing for ChEI initiation in MCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>ChEI use in MCI was associated with increased risk of progression to AD dementia.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>ChEI use in MCI was associated with accelerated longitudinal cognitive decline.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Cognitive decline persisted after ChEI initiation rather than reversing.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>ChEI effects on MCI progression to AD dementia were independent of A\u03b2 status.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70193","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T06:15:50Z","timestamp":1747289750000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The impact of cholinesterase inhibitors on cognitive trajectories in mild cognitive impairment patients based on amyloid beta status"],"prefix":"10.1002","volume":"21","author":[{"given":"Wenying","family":"Liu","sequence":"first","affiliation":[{"name":"Innovation Center for Neurological Disorders and Department of Neurology National Clinical Research Center for Geriatric Diseases Xuanwu Hospital Capital Medical University  Beijing P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Innovation Center for Neurological Disorders and Department of Neurology National Clinical Research Center for Geriatric Diseases Xuanwu Hospital Capital Medical University  Beijing P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Qin","sequence":"additional","affiliation":[{"name":"Innovation Center for Neurological Disorders and Department of Neurology National Clinical Research Center for Geriatric Diseases Xuanwu Hospital Capital Medical University  Beijing P.R. China"},{"name":"Beijing Key Laboratory of Geriatric Cognitive Disorders  Beijing P.R. China"},{"name":"Clinical Center for Neurodegenerative Disease and Memory Impairment Capital Medical University  Beijing P.R. 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China"},{"name":"Beijing Key Laboratory of Geriatric Cognitive Disorders  Beijing P.R. China"},{"name":"Clinical Center for Neurodegenerative Disease and Memory Impairment Capital Medical University  Beijing P.R. China"},{"name":"Center of Alzheimer's Disease Beijing Institute of Brain Disorders Collaborative Innovation Center for Brain Disorders Capital Medical University  Beijing P.R. China"},{"name":"Key Laboratory of Neurodegenerative Diseases Ministry of Education  Beijing P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[{"name":"Innovation Center for Neurological Disorders and Department of Neurology National Clinical Research Center for Geriatric Diseases Xuanwu Hospital Capital Medical University  Beijing P.R. China"},{"name":"Beijing Key Laboratory of Geriatric Cognitive Disorders  Beijing P.R. 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