The effects of commonly prescribed drugs in patients with Alzheimer's disease on the rate of deterioration

Abstract

Background: Prescribed drugs in patients with Alzheimer's disease may affect the symptomatic progression of their disease, both positively and negatively. Aim: To examine the effects of drugs on the progression of disease in a representative group of patients with Alzheimer's disease. Methods: Patients with the diagnosis of probable Alzheimer's disease were recruited from the community. The prescribed drugs taken by 224 patients (mean age 82.3 years) were recorded at initial assessment and then correlated in logistic regression analysis with progression of the disease, defined as an increase of one point or more in the Global Deterioration Scale over the next 12-month period. Results: Patients who were taking antipsychotic drugs and sedatives had a significantly higher risk of deterioration than those who were taking none (odds ratios (ORs) 2.74 (95% confidence interval (CI) 1.17 to 6.41) and 2.77 (95% CI 1.14 to 6.73), respectively). Higher risk of deterioration was observed in those who were taking both antipsychotic and sedative drugs together (OR 3.86 (95% CI 1.28 to 11.7). Patients taking drugs licensed for dementia, drugs affecting the renin-angiotensin system and statins had a significantly lower risk of deterioration than those who were not taking any of these drugs (ORs 0.49 (95% CI 0.25 to 0.97), 0.31 (95% CI 0.11 to 0.85) and 0.12 (95% CI 0.03 to 0.52), respectively). Conclusion: Our findings have implications for both clinicians and trialists. Most importantly, clinicians should carefully weigh any potential benefits of antipsychotics and benzodiazepines, especially in combination, against the risk of increased decline. Researchers need to be aware of the potential of not only licensed drugs for dementia but also drugs affecting the renin-angiotensin system and statins in reducing progression in clinical trials.

Aging of perennial cells and organ parts according to the programmed aging paradigm

“…Moreover, there is an association between AD and cardiovascular risk factors (Vogel et al 2006;Rosendorff et al 2007). Drugs, such as statins, ACE inhibitors, and sartans, which are all considered "protective drugs" for cardiovascular diseases, are effective against AD (Vogel et al 2006;Ellul et al 2007).…”

Cerebroprotective effects of RAS inhibitors: Beyond their cardio-renal actions

“…33 Therefore, ACE inhibitors appear to impact the central RAS together with their effect on the peripheral RAS. 34 Memory-enhancing effects of captopril are more particularly on short-term memory, assessed through Y-maze, than on long-term memory. Results of this study demonstrated that ACE inhibitors had shown significant increase in both antioxidant enzyme levels, i.e.…”

Central Nervous System Drug Consumption Depending on the Time between Symptom Onset and the Diagnosis of Alzheimer’s Disease: An Analysis by the Registry of Dementias of Girona

“…Today, AD patients are broadly treated with antidementia drugs to improve cognitive and functional domains [13], and with neuroleptics, antidepressants, anxiolytics and other drugs to deal with behavioral and psychological symptoms [14]. So far, some studies have analyzed the drug prescription patterns in patients with AD, and most of them have focused on nursing homes, community-dwelling patients, or in specific drugs or families of drugs [15,16,17,18,19]. Besides, some authors describe medication patterns according to the severity of the dementia [20], but to our knowledge, there are no reports examining whether differences exist between the central nervous system (CNS) drug consumption pattern of individuals who are diagnosed as having AD, depending on the time elapsed between the first symptoms and the diagnosis.…”