Supplementary materials for: Long term effects of cholinesterase inhibitors on cognitive decline and mortality

Objective: Cholinesterase inhibitors (ChEIs) are the mainstay treatment of Alzheimer’s dementia (AD), but their long-term effectiveness is uncertain. This study aims is to investigate whether ChEIs are associated with slower cognitive decline in AD, and decreased risk of severe dementia or death.

Methods: AD patients from the Swedish Dementia Registry (SveDem) starting on ChEIs within three months of the dementia diagnosis were included and compared to non-treated AD patients. In a propensity score matched cohort, the association between ChEI-use and cognitive trajectories assessed by MMSE scores were examined with a mixed model, and severe dementia (MMSE<10) or death as outcomes with Cox proportional hazards models.

Results: The matched cohort included 11,652 ChEI-use and 5,826 non-users. During an average of 5 years follow up, 255 cases developed severe dementia and 6,055 (35%) died. ChEI-use was associated with higher MMSE at each visit (0.13 MMSE points/year; 95% confidence...