Deprescribing Cholinesterase Inhibitors in Dementia : A Scoping Review of International Practice Guidance to Inform Korean Guideline Development

Background : South Korea is experiencing a rapidly aging population, leading to an increase in the prescription of anti-dementia drugs.Despite this trend, standardized protocols for discontinuing these medicationsare not yet established.This study aims to analyze international deprescribing guidelines for cholinesterase inhibitors to lay the groundwork for developing clinical practice guidelines specific to Korea. Methods: A scoping review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.We searched MEDLINE, EMBASE, the Cochrane Library, and grey literature for guidelines published between 2015 and 2025.The Template for Intervention Description and Replication checklist was used to systematically extract details about interventions, including deprescribing criteria, tapering protocols, and the involvement of pharmacists.Results : Thirteen publications were identified, primarily focusing on severe Alzheimer's disease in community settings and nursing homes.Common triggers for deprescribing included the absence of cognitive benefits and adverse events.Most guidelines (61.5%) did not provide specific quantitative values for deprescribing criteria, such as Mini-Mental State Examination or Functional Assessment Staging Tool scores.While most guide-진이 심각한 부작용이 발생하지 않는 한 약물을 유지하는 것을 우선하고 있음을 시사한다. 10)반면 프랑스는 2018년 이들 약