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I enjoyed reading the article by Dr Scarmeas and colleagues¹ detailing the results of their carefully planned cohort study. This study examined the association between the presence of hallucinations and delusions and the development of clinically important outcomes (eg, decline on a cognitive outcome, decline on a functional outcome, institutionalization, and death). In modeling the effects of hallucinations and delusions on these outcomes, the investigators adjusted for the use of neuroleptic drugs (ie, antipsychotics) and cholinesterase inhibitors. The authors provided data on the relationship between neuroleptic drug use and the clinical outcomes, and a recent meta-analysis shed further light on the potential risks of neuroleptic drug treatment in dementia.² I wonder if Dr Scarmeas and colleagues can provide further insights into the influence of cholinesterase inhibitors on their measured outcomes.

There has been ongoing debate about the value of cholinesterase inhibitor treatment. Although some studies have identified little meaningful benefit . . . [Full Text of this Article]

AUTHOR INFORMATION

Sudeep S. Gill, MD, MSc, FRCPC

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