Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data
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 ele...
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/16/4661 |
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| author | Minjae Kang Dan Bee Lee Sungchan Kwon Eun Lee Woo Jung Kim |
| author_facet | Minjae Kang Dan Bee Lee Sungchan Kwon Eun Lee Woo Jung Kim |
| author_sort | Minjae Kang |
| collection | DOAJ |
| description | 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 (<i>n</i> = 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, <i>p</i> = 0.009), and the difference was consistent in the highly adherent subjects (F = 10.16, <i>p</i> = 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, <i>p</i> = 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. |
| first_indexed | 2024-03-09T09:55:16Z |
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| language | English |
| last_indexed | 2024-03-09T09:55:16Z |
| publishDate | 2022-08-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-52f40d02ff584774b8814e13379c00a42023-12-01T23:49:55ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116466110.3390/jcm11164661Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World DataMinjae Kang0Dan Bee Lee1Sungchan Kwon2Eun Lee3Woo Jung Kim4Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaMedical Information Team, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, KoreaDivision of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaMedical Information Team, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, KoreaThe 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 (<i>n</i> = 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, <i>p</i> = 0.009), and the difference was consistent in the highly adherent subjects (F = 10.16, <i>p</i> = 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, <i>p</i> = 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.https://www.mdpi.com/2077-0383/11/16/4661cholinesterase inhibitorsnootropic agentsdementiaAlzheimer diseasecognitive dysfunctionmental status and dementia test |
| spellingShingle | Minjae Kang Dan Bee Lee Sungchan Kwon Eun Lee Woo Jung Kim Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data Journal of Clinical Medicine cholinesterase inhibitors nootropic agents dementia Alzheimer disease cognitive dysfunction mental status and dementia test |
| title | Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data |
| title_full | Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data |
| title_fullStr | Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data |
| title_full_unstemmed | Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data |
| title_short | Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data |
| title_sort | effectiveness of nootropics in combination with cholinesterase inhibitors on cognitive function in mild to moderate dementia a study using real world data |
| topic | cholinesterase inhibitors nootropic agents dementia Alzheimer disease cognitive dysfunction mental status and dementia test |
| url | https://www.mdpi.com/2077-0383/11/16/4661 |
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