Dementia with Lewy bodies is a type of dementia similar to Alzheimer’s and Parkinson’s disease, but studies on long-term treatments are lacking. A new study from the Karolinska Institutet in Sweden, published in Alzheimer’s and dementiahighlights the potential cognitive benefits of cholinesterase inhibitor treatment.

Lewy body disease, which includes dementia with Lewy bodies (DLB) and Parkinson’s disease with and without dementia, is the second most common neurodegenerative disorder after Alzheimer’s disease. DLB accounts for approximately 10-15% of dementia cases and is characterized by changes in sleep, behavior, cognition, movement, and regulation of automatic body functions.

“There are currently no approved treatments for DLB, so doctors often use Alzheimer’s medications, such as cholinesterase inhibitors and memantine, for symptom relief,” says Hong Xu, assistant professor at the Department of Neurobiology, Health Sciences and Society, Karolinska Institutet and first author of the paper. “However, the effectiveness of these treatments remains uncertain due to inconsistent trial results and limited long-term data.”

In the current study, researchers compared the long-term effects of cholinesterase inhibitors (ChEIs) and memantine with no treatment for up to 10 years in 1,095 patients with DLB. They found that ChEIs can slow cognitive decline for five years compared with memantine or no treatment. ChEIs were also associated with a reduced risk of death in the first year after diagnosis.

“Our results highlight the potential benefits of ChEIs for patients with DLB and support updating treatment guidelines,” said Maria Eriksdotter, professor at the Department of Neurobiology, Health Sciences and Society at the Karolinska Institutet and last author of the paper.

Due to the observational nature of the study, no conclusions can be drawn about causality. The researchers did not have data on the patients’ lifestyle habits, frailty, blood pressure, and co-pathology of Alzheimer’s disease, which could have affected the findings. Another limitation of the study is that it remains difficult to accurately diagnose DLB.