Low‐dose acetylsalicylic use shows protective association with Alzheimer’s disease incidence: Results from two large prospective cohort studies

Background.Antihypertensive drug use is inconsistently associated with the risk of dementia, Alzheimer’s disease, cognitive impairment, and cognitive decline. Therefore, we conducted a meta-analysis of available prospective cohort studies to summarize the evidence on the strength of these relationships.Methods.Three electronic databases including MedLine, Embase, and the Cochrane Library were searched to identify studies from inception to April 2017. Only prospective cohort studies that reported effect estimates with corresponding 95% confidence intervals (CIs) of dementia, Alzheimer’s disease, cognitive impairment, and cognitive decline for antihypertensive drug use versus not using antihypertensive drugs were included.Results.We included 10 prospective cohort studies reporting data on 30,895 individuals. Overall, participants who received antihypertensive drugs had lower incidence of dementia (relative risk [RR]: 0.86; 95% CI: 0.75–0.99;p=0.033), while there was no significant effect on the incidence of Alzheimer’s disease (RR: 0.83; 95% CI: 0.64–1.09;p=0.154), cognitive impairment (RR: 0.89; 95% CI: 0.57–1.38;p=0.596), and cognitive decline (RR: 1.11; 95% CI: 0.86–1.43;p=0.415). Further, the incidence of Alzheimer’s disease might be affected by antihypertensive drug use in participants with specific characteristics.Conclusions.Antihypertensive drug use was associated with a significantly reduced risk of dementia, but not with the risk of Alzheimer’s disease, cognitive impairment, and cognitive decline.

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Homocysteine and Folic Acid: Risk Factors for Alzheimer's Disease—An Updated Meta-Analysis

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.665114 ◽

2021 ◽

Vol 13 ◽

Author(s):

Qianwen Wang ◽

Jingjing Zhao ◽

Hongtao Chang ◽

Xu Liu ◽

Ruixia Zhu

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Folic Acid ◽

Cohort Studies ◽

Prospective Cohort ◽

Meta Analysis ◽

Case Control ◽

Case Control Studies ◽

Prospective Cohort Studies ◽

Increased Risk

Background: Recent studies have reported that homocysteine (Hcy) may play a vital role in the pathogenesis of vascular dementia (VaD) and Alzheimer's disease (AD). Our study explored the relationship between the plasma Hcy and folate levels and the risk of dementia.Methods: We searched Embase, PubMed, and Web of Science for published literature, including case-control studies and prospective cohort studies, and performed a systematic analysis.Results: The results of our meta-analysis, consisting of case-control studies, showed higher levels of Hcy and lower levels of folate in dementia, AD, and VaD patients than those in non-demented controls (for dementia: SMD = 0.812, 95% CI [0.689, 0.936], p = 0.000 for Hcy; SMD = −0.677, 95% CI [−0.828, −0.525], p = 0.000 for folate). AD patients showed significantly lower plasma Hcy levels compared to VaD patients (SMD = −0.278, 95% CI [−0.466, −0.09], p = 0.000). Subgroup analysis revealed that ethnicity, average age, and dementia type had no significant effect on this association. Furthermore, from the analysis of prospective cohort studies, we identified that elevated plasma Hcy levels were associated with an increased risk of dementia, AD, and VaD (RRdementia = 1.22, 95% CI [1.08, 1.36]; RRAD = 1.07, 95% CI [1.04, 1.11]; RRVaD = 1.13, 95% CI [1.04, 1.23]). In addition, every 5 μmol/L increase in the plasma Hcy level was associated with a 9% increased risk of dementia and a 12% increased risk of AD.Conclusion: Hcy and folic acid are potential predictors of the occurrence and development of AD. A better understanding of their function in dementia could provide evidence for clinicians to rationalize clinical intervention strategies.

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