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- W4383481710 abstract "Cognitive enhancers are the primary pharmacological therapy prescribed to those with dementia, comprising of memantine and the acetylcholinesterase inhibitors (AChEIs). The long-term cognitive and behavioural benefits of these medications, as well as their potential contribution to falls is currently debated, with recent Delphi studies being unable to reach consensus on whether these medications should be deprescribed. In this narrative clinical review, as part of a series on deprescribing in people at risk of falls, we explore the potential falls-related side effects experienced in people taking cognitive enhancers, alongside situations where deprescribing may be appropriate.We undertook a literature search of PubMed and Google Scholar, using terms capturing falls and cognitive enhancers, as well as consulting the British National Formulary and published Summary of Medicinal Product Characteristics. These searches informed the subsequent clinical review.Cognitive enhancers should be subject to regular review, including confirmation of appropriate treatment indication, and occurrence of side effects in the context of falls. AChEIs, in particular, are associated with a broad range of side effects that can contribute to increased falls risk. These include bradycardia, syncope and neuromuscular effects. Where these have been identified, deprescribing should be considered, as well as alternative treatment options. Deprescribing studies have shown mixed results, likely due to considerable methodological heterogeneity. Several suggested guidelines exist to aid deprescribing decisions, many of which are highlighted in this review.The use of cognitive enhancers should be regularly reviewed and decisions to deprescribe made on a case-by-case basis, considering both the risks and benefits of stopping these medications." @default.
- W4383481710 created "2023-07-08" @default.
- W4383481710 creator A5000552507 @default.
- W4383481710 creator A5025768536 @default.
- W4383481710 creator A5067808014 @default.
- W4383481710 creator A5087306934 @default.
- W4383481710 date "2023-07-07" @default.
- W4383481710 modified "2023-09-27" @default.
- W4383481710 title "Therapeutic dilemmas: cognitive enhancers and risk of falling in older adults—a clinical review" @default.
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- W4383481710 doi "https://doi.org/10.1007/s41999-023-00821-x" @default.
- W4383481710 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37418063" @default.