Nonsteroidal anti-inflammatory drug use and the risk of cognitive impairment and Alzheimer's disease

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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Automated multi-dose dispensing in persons with and without Alzheimer’s disease—impacts on pharmacotherapy

European Journal of Clinical Pharmacology ◽

10.1007/s00228-021-03258-y ◽

2021 ◽

Author(s):

Sanna Vallius ◽

Heidi Taipale ◽

Marjaana Koponen ◽

Anna-Maija Tolppanen ◽

Antti Tanskanen ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Drug Use ◽

Community Dwelling ◽

Point Prevalence ◽

Study Cohort ◽

Before And After ◽

Benzodiazepine Use ◽

Inflammatory Drugs ◽

Anti Inflammatory

Abstract Purpose We investigated the drug use before and after transition to automated multi-dose dispensing (MDD) service among persons with Alzheimer’s disease (AD) and compared whether the changes were similar in persons without AD. Methods The register-based Finnish nationwide MEDALZ cohort includes 70,718 community-dwelling persons diagnosed with AD during 2005–2011. Each person who initiated MDD was matched in both groups with a comparison person without MDD by age, gender and for persons with AD, also time since AD diagnosis at the start of MDD. The study cohort included 15,604 persons with AD in MDD and 15,604 no-MDD, and 5224 persons without AD in MDD and 5224 no-MDD. Point prevalence of drug use was assessed every 3 months, from 1 year before to 2 years after the start of MDD and compared between persons in MDD to those who did not have MDD. Results MDD was started on average 2.9 (SD 2.1) years after AD diagnosis. At the start of MDD, the prevalence of drug use increased especially for antipsychotics, antidepressants, opioids, paracetamol and use of ≥ 10 drugs among persons with and without AD. Prevalence of benzodiazepine use (from 12% 12 months before to 17% at start of MDD), memantine (from 29 to 46%) and ≥ 3 psychotropics (from 3.2 to 6.0%) increased among persons with AD. Decreasing trend was observed for benzodiazepine-related drugs, urinary antispasmodics and non-steroidal anti-inflammatory drugs. Conclusion MDD seems to be initiated when use of psychotropics is initiated and the number of drugs increases.

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