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Mark Chan, MBBS

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The study by Gill et al¹ suggested a higher risk of adverse outcomes including syncope, bradycardia, pacemaker insertions, and hip fractures in community-dwelling adults with dementia receiving cholinesterase inhibitors compared with well-matched controls. These findings have important implications, as the agents in question remain the mainstay of symptomatic treatment for an otherwise debilitating illness.

It is interesting to note that while the incidence of hospital visits for syncope are comparatively higher in the cholinesterase inhibitor cohort (2.2% vs 1.5% in controls, see Table 3 in Gill et al¹), the incidences for all other adverse outcomes are actually almost identical between cholinesterase inhibitor and control groups (hospital visits for bradycardia, 0.5% vs 0.4%; pacemaker insertions, 0.3% vs 0.3%; and hospitalizations for hip fractures, 1.6% vs 1.6%). The significant difference noted in the event rates and subsequent hazard ratios are therefore mainly influenced by the shorter follow-up periods . . . [Full Text of this Article]

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RELATED ARTICLE

Syncope and Its Consequences in Patients With Dementia Receiving Cholinesterase Inhibitors: A Population-Based Cohort Study
Sudeep S. Gill, Geoffrey M. Anderson, Hadas D. Fischer, Chaim M. Bell, Ping Li, Sharon-Lise T. Normand, and Paula A. Rochon
Arch Intern Med. 2009;169(9):867-873.
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Adverse Events in Patients Receiving Cholinesterase Inhibitors Due to Dissimilar Follow-up Periods—Reply
Sudeep S. Gill, Chaim M. Bell, and Paula A. Rochon
Arch Intern Med. 2009;169(18):1724-1725.
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