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Discontinuation of donepezil (Aricept) treatment for patients with moderate to severe Alzheimer’s impacts whether they go into a nursing home, but only for the first year, according to a new study.

In a yearlong study with a three-year follow-up, patients at secondary care memory centers in England and Scotland were tracked to see whether they remained at home. Discontinuation of donepezil treatment was associated with an increased risk of nursing home placement within a year, with the highest risk over the first six months. After a year, those who discontinued were at no higher risk than those who remained on the medication, according to researchers at the Center for Alzheimer Research in Stockholm.

Donepezil is an cholinesterase inhibitor that reduces or prevents acetylcholine breakdown in brain tissue, and improves memory and the ability to function in some patients.

The study, published in Nature, conflicts with a fall 2015 study that said physicians were stopping the drug too early. However, there is debate over the medication’s cost versus the benefits. Research published in JAMA Internal Medicine in 2014 suggested more than 50% of dementia patients were receiving “medication of questionable benefit,” such as Aricept and memantine, where the average 90-day expenditure for the drugs was $816.

Nursing home placement is considered a milestone for dementia researchers, as it marks a shift in the disease and increases the cost of care, the Swedish researchers wrote.

“Despite the demonstrated efficacy of AChEIs, whether or not treatment with them should be continued in the advanced stages of AD is still a matter of debate,” researchers wrote. There is weak evidence to support combining AChEI with memantine, which is often prescribed for dementia-related behavioral symptoms, they added.

Full results were published in Nature in January 2016.