I want to know if coffee is better for dementia prevention or my Nifedipine use (a calcium channel blocker). WHOM will know that answer? It is a fuckingly simple question. I don't care that the answer will be hard to figure out. Living with a stroke is hard.
Coffee May Lower Your Risk of Dementia Feb. 2013
Use of Antihypertensives Associated With Decreased Risk of Dementia
Antihypertensive
drug use is negatively associated with dementia in elderly persons
followed in general practices in Germany, according to a study published
in the Journal of Alzheimer’s Disease.
“After another setback for the anti-amyloid strategy, dementia prevention is increasingly becoming an area of interest,” said Jens Bohlken, MD, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany. “In view of this, our most important task is to find existing therapies that are associated with a reduction in dementia risk or at least an extension of the time to dementia onset.”
This study was based on data from the Disease Analyzer database (IQVIA), which compiles drug prescriptions, diagnoses, and basic medical and demographic data obtained directly and in anonymous format from computer systems used in the practices of general practitioners and specialists.
Researchers included 12,405 patients with documented blood pressure values and an initial diagnosis of all-cause dementia in 739 general practices in Germany between January 2013 and December 2017 (index date). Inclusion criteria were as follows: age 60 years at the index date, observation time of at least 12 months prior to the index date, and hypertension diagnosis prior to the index date.
After applying similar inclusion criteria, dementia cases were matched to 12,405 controls without dementia using propensity scores based on age, sex, index year, and co-diagnoses (ie, diabetes, hyperlipidaemia, stroke, heart disease, depression, intracranial injury, Parkinson’s disease, osteoporosis, and epilepsy). For the controls, the index date was that of a randomly selected visit between January 2013 and December 2017.
The primary outcome was the incidence of dementia as a function of the use of antihypertensive drugs.
The use of angiotensin II receptor blockers (odds ratios [ORs], 0.74-0.79), angiotensin-converting enzyme (ACE) inhibitors (ORs, 0.85-0.88), calcium channel blockers (ORs, 0.82-0.89), and beta blockers (OR = .88) were all associated with a decrease in dementia incidence.
In patients treated with calcium channel blockers, increasing the duration of treatment decreased the incidence of dementia.
“Antihypertensive therapy alone cannot guarantee that dementia will never occur,” noted Karel Kostev, PhD, IQVIA, Germany, Mannheim, Germany. “However, these findings highlight the importance of the prescription of antihypertensive drugs in the context of preventing hypertension-associated cognitive decline.”
The authors of the study also noted that further studies are needed to gain a better understanding of the medications associated with a decreased risk of dementia.
“We plan to investigate the role of lipid-lowering drugs, antidepressants, and further medications in the future,” they said.
The study is subject to some limitations, as the patients in the study were all aged 60 years or older, and this inclusion criterion was necessary for identifying dementia. However, previous research has shown that it is important for a life course-related prevention strategy to initiate hypertension treatment at a younger age. Moreover, data on patients’ lifestyle factors, including smoking and physical activity, education, and job, were also lacking. The strengths of this study are the number of patients available for analysis, which allowed the use of a case-control design, and the use of real-world data, with different diagnoses and medications available for analysis.
Reference: http://dx.doi.org/10.3233/JAD-190362
SOURCE: IOS Press
“After another setback for the anti-amyloid strategy, dementia prevention is increasingly becoming an area of interest,” said Jens Bohlken, MD, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany. “In view of this, our most important task is to find existing therapies that are associated with a reduction in dementia risk or at least an extension of the time to dementia onset.”
This study was based on data from the Disease Analyzer database (IQVIA), which compiles drug prescriptions, diagnoses, and basic medical and demographic data obtained directly and in anonymous format from computer systems used in the practices of general practitioners and specialists.
Researchers included 12,405 patients with documented blood pressure values and an initial diagnosis of all-cause dementia in 739 general practices in Germany between January 2013 and December 2017 (index date). Inclusion criteria were as follows: age 60 years at the index date, observation time of at least 12 months prior to the index date, and hypertension diagnosis prior to the index date.
After applying similar inclusion criteria, dementia cases were matched to 12,405 controls without dementia using propensity scores based on age, sex, index year, and co-diagnoses (ie, diabetes, hyperlipidaemia, stroke, heart disease, depression, intracranial injury, Parkinson’s disease, osteoporosis, and epilepsy). For the controls, the index date was that of a randomly selected visit between January 2013 and December 2017.
The primary outcome was the incidence of dementia as a function of the use of antihypertensive drugs.
The use of angiotensin II receptor blockers (odds ratios [ORs], 0.74-0.79), angiotensin-converting enzyme (ACE) inhibitors (ORs, 0.85-0.88), calcium channel blockers (ORs, 0.82-0.89), and beta blockers (OR = .88) were all associated with a decrease in dementia incidence.
In patients treated with calcium channel blockers, increasing the duration of treatment decreased the incidence of dementia.
“Antihypertensive therapy alone cannot guarantee that dementia will never occur,” noted Karel Kostev, PhD, IQVIA, Germany, Mannheim, Germany. “However, these findings highlight the importance of the prescription of antihypertensive drugs in the context of preventing hypertension-associated cognitive decline.”
The authors of the study also noted that further studies are needed to gain a better understanding of the medications associated with a decreased risk of dementia.
“We plan to investigate the role of lipid-lowering drugs, antidepressants, and further medications in the future,” they said.
The study is subject to some limitations, as the patients in the study were all aged 60 years or older, and this inclusion criterion was necessary for identifying dementia. However, previous research has shown that it is important for a life course-related prevention strategy to initiate hypertension treatment at a younger age. Moreover, data on patients’ lifestyle factors, including smoking and physical activity, education, and job, were also lacking. The strengths of this study are the number of patients available for analysis, which allowed the use of a case-control design, and the use of real-world data, with different diagnoses and medications available for analysis.
Reference: http://dx.doi.org/10.3233/JAD-190362
SOURCE: IOS Press
