{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T10:39:08Z","timestamp":1777113548770,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n To compare the longitudinal cognitive changes of AChEIs and mAbs separately across three different cognitive measurements.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a systematic review and meta\u2010analysis of randomized controlled trials (RCTs) in individuals with mild cognitive impairment (MCI) or mild Alzheimer's disease (AD). Major databases (PubMed, Embase, CENTRAL, PsycINFO, and\n ClinicalTrials.gov<\/jats:ext-link>\n ) were searched from inception to April 6, 2025. The primary outcomes were changes in the Alzheimer's Disease Assessment Scale\u2014Cognitive Subscale\u201014 Items (ADAS\u2010Cog), Mini\u2010Mental State Examination (MMSE), and Clinical Dementia Rating\u2013Sum of Boxes (CDR\u2010SB).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall, monoclonal antibodies (7 trials,\n n<\/jats:italic>\n \u2009=\u20098010) exhibited comparatively homogeneous and an increasing separation from placebo over time within trials, whereas acetylcholinesterase inhibitors (9 trials,\n n<\/jats:italic>\n \u2009=\u20094993) showed greater heterogeneity and an apparent attenuation of effect with longer follow\u2010up. On ADAS\u2010Cog, acetylcholinesterase inhibitors demonstrated a nonsignificant pooled effect with substantial heterogeneity (MD\u2009=\u2009\u22120.24, 95% CI \u22121.22 to 0.73;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200976%), whereas monoclonal antibodies were associated with a statistically significant and relatively consistent improvements within trials (MD\u2009=\u2009\u22121.27, 95% CI \u22121.69 to \u22120.84;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%). On MMSE and CDR\u2010SB, acetylcholinesterase inhibitors yielded modest and borderline effects, respectively (MMSE MD\u2009=\u20090.10, 95% CI 0.07 to 0.13; CDR\u2010SB MD\u2009=\u2009\u22120.11, 95% CI \u22120.22 to 0), whereas monoclonal antibodies showed statistically significant benefits (MMSE MD\u2009=\u20090.42, 95% CI 0.07 to 0.77; CDR\u2010SB MD\u2009=\u2009\u22120.41, 95% CI \u22120.62 to \u22120.20). For CDR\u2010SB, AChEIs showed minimal statistical heterogeneity (\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%) despite variable individual trajectories, whereas mAbs showed moderate heterogeneity (\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200956%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In patients with MCI or mild AD, mAbs showed consistent efficacy on MMSE and ADAS\u2010Cog but demonstrated heterogeneous effects on CDR\u2010SB. In contrast, AChEIs showed heterogeneous and modest efficacy across all three measurements. These findings should be interpreted with caution due to the study's limitations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ggi.70492","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T09:53:23Z","timestamp":1776333203000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Multi\u2010Domain Cognitive Assessment of Anti\u2010Amyloid Monoclonal Antibodies Versus Acetylcholinesterase Inhibitors in Early Alzheimer's Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"26","author":[{"given":"Chuo\u2010Yu","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurology Mackay Memorial Hospital Taipei Taiwan"},{"name":"Department of Medicine Mackay Medical College New Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tien\u2010Wei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, E\u2010DA Dachang Hospital I\u2010Shou University Kaohsiung Taiwan"},{"name":"Department of Psychiatry, E\u2010DA Hospital I\u2010Shou University Kaohsiung Taiwan"},{"name":"Graduate Institute of Clinical Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Chen","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Tri\u2010Service General Hospital National Defense Medical Centre Taipei Taiwan"},{"name":"Department of Psychiatry, Beitou Branch Tri\u2010Service General Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping\u2010Tao","family":"Tseng","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Sciences National Sun Yat\u2010sen University Kaohsiung Taiwan"},{"name":"Department of Psychology, College of Medical and Health Science Asia University Taichung Taiwan"},{"name":"Prospect Clinic for Otorhinolaryngology & Neurology Kaohsiung Taiwan"},{"name":"Institute of Precision Medicine National Sun Yat\u2010sen University Kaohsiung City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8650-4060","authenticated-orcid":false,"given":"Chih\u2010Wei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Kaohsiung Chang Gung Memorial Hospital Kaohsiung City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9393-3886","authenticated-orcid":false,"given":"Yu\u2010Hsuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Population Health Sciences National Health Research Institutes Miaoli County Taiwan"},{"name":"Department of Psychiatry National Taiwan University Hospital Taipei Taiwan"},{"name":"Department of Psychiatry, College of Medicine National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1138-5586","authenticated-orcid":false,"given":"Chih\u2010Sung","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Tri\u2010Service General Hospital National Defense Medical Centre Taipei Taiwan"},{"name":"Department of Psychiatry, Beitou Branch Tri\u2010Service General Hospital Taipei 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