How useful are cholinesterase inhibitors in the treatment of Alzheimer's disease? A number needed to treat analysis

Int J Geriatr Psychiatry. 2000 Mar;15(3):203-7. doi: 10.1002/(sici)1099-1166(200003)15:3<203::aid-gps100>;2-9.


Objectives: To report on a Numbers Needed to Treat (NNT) analysis of the literature identified through a systematic review of trials of cholinesterase inhibitors in Alzheimer's Disease.

Design: Search of Medline (1966-1998), EMBASE (1994-1999) and Psychlit (1974-1998) using the keywords cholinesterase and placebo dementia.

Settings: Double-blind, randomised, placebo-controlled trials.

Subjects: People with Alzheimer's Disease.

Interventions: Drug trials of acetylcholinesterase inhibitors (ChIs). Main outcome measuresAlzheimer's Disease Assessment Scale (Cognitive subscale), Clinician's Interview Based Impression of Change Plus, Mini Mental State Examination, Progressive Deterioration Scale.

Results: Small numbers of patients (in most cases between 3 and 7) need to be treated with appropriate dosages of ChIs to ameliorate the clinical symptoms, or postpone deterioration in one of them.

Conclusions: These small NNTs suggest that, despite their expense, the cholinesterase inhibitors have a valuable place in the current clinical management of AD.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Alzheimer Disease / drug therapy*
  • Cholinesterase Inhibitors / therapeutic use*
  • Humans
  • Randomized Controlled Trials as Topic / statistics & numerical data


  • Cholinesterase Inhibitors