Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease

作者：Michal Rolinski, Chris Fox, Ian D. Maidment, Rupert H. McShane · 发表于：Cochrane Database of Systematic Reviews · 年份：2012 · DOI：10.1002/14651858.cd006504.pub2 · 被引用次数：419 · 研究领域：Parkinson's Disease Mechanisms and Treatments、Cholinesterase and Neurodegenerative Diseases、Dementia and Cognitive Impairment Research

BACKGROUND: Previous Cochrane reviews have considered the use of cholinesterase inhibitors in both Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB). The clinical features of DLB and PDD have much in common and are distinguished primarily on the basis of whether or not parkinsonism precedes dementia by more than a year. Patients with both conditions have particularly severe deficits in cortical levels of the neurotransmitter acetylcholine. Therefore, blocking its breakdown using cholinesterase inhibitors may lead to clinical improvement. OBJECTIVES: To assess the efficacy, safety and tolerability of cholinesterase inhibitors in dementia with Lewy bodies (DLB), Parkinson's disease with dementia (PDD), and cognitive impairment in Parkinson's disease falling short of dementia (CIND-PD) (considered as separate phenomena and also grouped together as Lewy body disease). SEARCH METHODS: The trials were identified from a search of ALOIS, the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group (on 30 August 2011) using the search terms Lewy, Parkinson, PDD, DLB, LBD. This register consists of records from major healthcare databases (MEDLINE, EMBASE, PsycINFO, CINAHL) and many ongoing trial databases and is updated regularly.Reference lists of relevant studies were searched for additional trials. SELECTION CRITERIA: Randomised, double-blind, placebo-controlled trials assessing the efficacy of treatment with cholinesterase inhibitors i...