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We thank Dr Gill for the positive comments about our study. Because the Predictors study started more than 14 years ago, when cholinesterase medications were not available, only 41% of the patients used in our analyses were ever prescribed these medications. In models such as those used in our report, we detected no significant association between use of cholinesterase inhibitors and any of the 4 outcomes (but there was a trend toward a protective effect for mortality).

One has to keep in mind that examination of the effect of medications is vulnerable to a variety of potential biases. Most important, this is an observational cohort and the medications were administered in a nonrandomized fashion. In our study, patients who received cholinesterase inhibitors were members of the more recent Predictors 2 cohort; were more likely to be men; and had fewer medical comorbidities, better cognitive performance, and better functional . . . [Full Text of this Article]

AUTHOR INFORMATION

Nikolaos Scarmeas, MD, MSc; Yaakov Stern, PhD

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