Plasma lipid levels in Alzheimer's disease patients treated by Donepezil hydrochloride: A cross-sectional study

Donepezil hydrochloride is a central acetylcholine esterase inhibitor that is widely used in Alzheimer disease (AD). We have recently observed some differences in lipid profile between occasional cases of Donepezil hydrochloride users (DU) and non-users (DNU). This prompted us to study the levels of plasma lipids in these two groups, cross-sectionally. The medical charts of patients with probable AD were screened for current use of Donepezil hydrochloride and lipids profile, along with other clinical and demographic data. A total number of 105 patients were identified and included in the final analysis. Patients were divided into two groups (DU and DNU). Plasma levels of lipids were recorded. Mann-Whitney or t-test for continuous variables and Fisher exact test for categorical variables were used to test for significant differences between the groups. Regression analysis was applied to identify independently the factors associated with lipid levels. Thirty-three patients were DU and 72 DNU. The two groups differed in terms of age, lipid levels and cognitive level. DU had statistically significant higher levels of triglycerides compared with those not using the drug (P=0.036), higher total cholesterol (P<0.001), higher LDL (P=0.001), and higher VLDL (P=0.029) levels. DU showed statistically significant high odds ratios for having higher cholesterol and triglycerides levels. Multivariate regression analysis showed that there are marked differences between DU and DNU with respect to plasma lipid profile, also after correcting for age and sex. The higher plasma levels of cholesterol and triglycerides may reflect an adverse effect of Donepezil hydrochloride. Alternatively, this may indicate that the effect of the medication may involve lipid metabolism, rather than other proposed mechanisms.