{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:28:13Z","timestamp":1791358093324,"version":"4.3.1"},"reference-count":24,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec id=\"S0007125020001361_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The efficacy of acetylcholinesterase inhibitors and memantine in the symptomatic treatment of Alzheimer's disease is well-established. Randomised trials have shown them to be associated with a reduction in the rate of cognitive decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125020001361_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the real-world effectiveness of acetylcholinesterase inhibitors and memantine for dementia-causing diseases in the largest UK observational secondary care service data-set to date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125020001361_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We extracted mentions of relevant medications and cognitive testing (Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores) from de-identified patient records from two National Health Service (NHS) trusts. The 10-year changes in cognitive performance were modelled using a combination of generalised additive and linear mixed-effects modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125020001361_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The initial decline in MMSE and MoCA scores occurs approximately 2 years before medication is initiated. Medication prescription stabilises cognitive performance for the ensuing 2\u20135 months. The effect is boosted in more cognitively impaired cases at the point of medication prescription and attenuated in those taking antipsychotics. Importantly, patients who are switched between agents at least once do not experience any beneficial cognitive effect from pharmacological treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125020001361_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study presents one of the largest real-world examination of the efficacy of acetylcholinesterase inhibitors and memantine for symptomatic treatment of dementia. We found evidence that 68% of individuals respond to treatment with a period of cognitive stabilisation before continuing their decline at the pre-treatment rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2020.136","type":"journal-article","created":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T03:18:07Z","timestamp":1595819887000},"page":"261-267","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":37,"title":["Real-world effectiveness, its predictors and onset of action of cholinesterase inhibitors and memantine in dementia: retrospective health record study"],"prefix":"10.1192","volume":"218","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8094-0902","authenticated-orcid":false,"given":"Nemanja","family":"Vaci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Koychev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Hun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrey","family":"Kormilitzin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azad","family":"Dehghan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goran","family":"Nenadic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejo","family":"Nevado-Holgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2020,7,27]]},"reference":[{"key":"S0007125020001361_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afm117"},{"key":"S0007125020001361_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-015-0103-3"},{"key":"S0007125020001361_ref10","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.58.3.417"},{"key":"S0007125020001361_ref1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410190305"},{"key":"S0007125020001361_ref4","doi-asserted-by":"publisher","DOI":"10.1590\/S1980-57642013DN70200009"},{"key":"S0007125020001361_ref22","unstructured":"22 National Institute for Health and Care Excellence. Donepezil, Galantamine, Rivastigmine and Memantine for the Treatment of Alzheimer's Disease. NICE, 2011 (https:\/\/www.nice.org.uk\/guidance\/TA217\/chapter\/1-Guidance)."},{"key":"S0007125020001361_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-0318-1_1"},{"key":"S0007125020001361_ref6","volume-title":"Cochrane Database Syst Rev","volume":"2","author":"Areosa","year":"2005"},{"key":"S0007125020001361_ref8","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-134"},{"key":"S0007125020001361_ref11","doi-asserted-by":"publisher","DOI":"10.1136\/ard.58.2008.i82"},{"key":"S0007125020001361_ref14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53221.x"},{"key":"S0007125020001361_ref16","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1819086116"},{"key":"S0007125020001361_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2990.1978.tb00545.x"},{"key":"S0007125020001361_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1402"},{"key":"S0007125020001361_ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7274.1445"},{"key":"S0007125020001361_ref18","doi-asserted-by":"publisher","DOI":"10.1037\/pag0000056"},{"key":"S0007125020001361_ref23","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-12-45"},{"key":"S0007125020001361_ref15","doi-asserted-by":"publisher","DOI":"10.1201\/9781315370279"},{"key":"S0007125020001361_ref12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0109484"},{"key":"S0007125020001361_ref9","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1557"},{"key":"S0007125020001361_ref19","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"S0007125020001361_ref24","doi-asserted-by":"publisher","DOI":"10.2165\/00002512-200825100-00006"},{"key":"S0007125020001361_ref13","doi-asserted-by":"publisher","DOI":"10.1053\/apnr.2000.9231"},{"key":"S0007125020001361_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00258-6"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125020001361","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T05:11:18Z","timestamp":1619586678000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125020001361\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,27]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["S0007125020001361"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2020.136","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.738395743.793578060","asserted-by":"object"}]},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,27]]},"assertion":[{"value":"Copyright \u00a9 The Authors 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}