Effects of cardiovascular medications on rate of functional decline in alzheimer disease

Paul B Rosenberg, M. M. Mielke, J. Tschanz, L. Cook, Chris Corcoran, K. M. Hayden, M. Norton, Peter V Rabins, R. C. Green, K. A. Welsh-Bohmer, John C.S. Breitner, R. Munger, Constantine G Lyketsos

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Evidence suggests that cardiovascular medications, including statins and antihypertensive medications, may delay cognitive decline in patients with Alzheimer dementia (AD). We examined the association of cardiovascular medication use and rate of functional decline in a population-based cohort of individuals with incident AD. METHODS: In the Dementia Progression Study of the Cache County Study on Memory, Health, and Aging, 216 individuals with incident AD were identified and followed longitudinally with in-home visits for a mean of 3.0 years and 2.1 follow-up visits. The Clinical Dementia Rating (CDR) was completed at each follow-up. Medication use was inventoried during in-home visits. Generalized least-squares random-effects regression was performed with CDR Sum of Boxes (CDR-Sum) as the outcome and cardiovascular medication use as the major predictors. RESULTS: CDR-Sum increased an average of 1.69 points annually, indicating a steady decline in functioning. After adjustment for demographic variables and the baseline presence of cardiovascular conditions, use of statins (p = 0.03) and beta-blockers (p = 0.04) was associated with a slower annual rate of increase in CDR-Sum (slower rate of functional decline) of 0.75 and 0.68 points respectively, while diuretic use was associated with a faster rate of increase in CDR-Sum (p = 0.01; 0.96 points annually). Use of calcium-channel blockers, angiotensin-converting enzyme inhibitors, digoxin, or nitrates did not affect the rate of functional decline. CONCLUSIONS: In this population-based study of individuals with incident AD, use of statins and beta-blockers was associated with delay of functional decline. Further studies are needed to confirm these results and to determine whether treatment with these medications may help delay AD progression.

Original languageEnglish (US)
Pages (from-to)883-892
Number of pages10
JournalAmerican Journal of Geriatric Psychiatry
Volume16
Issue number11
DOIs
StatePublished - Nov 2008

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Dementia
Alzheimer Disease
Hydroxymethylglutaryl-CoA Reductase Inhibitors
House Calls
Digoxin
Calcium Channel Blockers
Least-Squares Analysis
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Nitrates
Antihypertensive Agents
Population
Demography
Health

Keywords

  • Alzheimer disease
  • Medications
  • Prognosis
  • Risk factors in epidemiology

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Effects of cardiovascular medications on rate of functional decline in alzheimer disease. / Rosenberg, Paul B; Mielke, M. M.; Tschanz, J.; Cook, L.; Corcoran, Chris; Hayden, K. M.; Norton, M.; Rabins, Peter V; Green, R. C.; Welsh-Bohmer, K. A.; Breitner, John C.S.; Munger, R.; Lyketsos, Constantine G.

In: American Journal of Geriatric Psychiatry, Vol. 16, No. 11, 11.2008, p. 883-892.

Research output: Contribution to journalArticle

Rosenberg, PB, Mielke, MM, Tschanz, J, Cook, L, Corcoran, C, Hayden, KM, Norton, M, Rabins, PV, Green, RC, Welsh-Bohmer, KA, Breitner, JCS, Munger, R & Lyketsos, CG 2008, 'Effects of cardiovascular medications on rate of functional decline in alzheimer disease', American Journal of Geriatric Psychiatry, vol. 16, no. 11, pp. 883-892. https://doi.org/10.1097/JGP.0b013e318181276a
Rosenberg, Paul B ; Mielke, M. M. ; Tschanz, J. ; Cook, L. ; Corcoran, Chris ; Hayden, K. M. ; Norton, M. ; Rabins, Peter V ; Green, R. C. ; Welsh-Bohmer, K. A. ; Breitner, John C.S. ; Munger, R. ; Lyketsos, Constantine G. / Effects of cardiovascular medications on rate of functional decline in alzheimer disease. In: American Journal of Geriatric Psychiatry. 2008 ; Vol. 16, No. 11. pp. 883-892.
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AU - Corcoran, Chris

AU - Hayden, K. M.

AU - Norton, M.

AU - Rabins, Peter V

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N2 - BACKGROUND: Evidence suggests that cardiovascular medications, including statins and antihypertensive medications, may delay cognitive decline in patients with Alzheimer dementia (AD). We examined the association of cardiovascular medication use and rate of functional decline in a population-based cohort of individuals with incident AD. METHODS: In the Dementia Progression Study of the Cache County Study on Memory, Health, and Aging, 216 individuals with incident AD were identified and followed longitudinally with in-home visits for a mean of 3.0 years and 2.1 follow-up visits. The Clinical Dementia Rating (CDR) was completed at each follow-up. Medication use was inventoried during in-home visits. Generalized least-squares random-effects regression was performed with CDR Sum of Boxes (CDR-Sum) as the outcome and cardiovascular medication use as the major predictors. RESULTS: CDR-Sum increased an average of 1.69 points annually, indicating a steady decline in functioning. After adjustment for demographic variables and the baseline presence of cardiovascular conditions, use of statins (p = 0.03) and beta-blockers (p = 0.04) was associated with a slower annual rate of increase in CDR-Sum (slower rate of functional decline) of 0.75 and 0.68 points respectively, while diuretic use was associated with a faster rate of increase in CDR-Sum (p = 0.01; 0.96 points annually). Use of calcium-channel blockers, angiotensin-converting enzyme inhibitors, digoxin, or nitrates did not affect the rate of functional decline. CONCLUSIONS: In this population-based study of individuals with incident AD, use of statins and beta-blockers was associated with delay of functional decline. Further studies are needed to confirm these results and to determine whether treatment with these medications may help delay AD progression.

AB - BACKGROUND: Evidence suggests that cardiovascular medications, including statins and antihypertensive medications, may delay cognitive decline in patients with Alzheimer dementia (AD). We examined the association of cardiovascular medication use and rate of functional decline in a population-based cohort of individuals with incident AD. METHODS: In the Dementia Progression Study of the Cache County Study on Memory, Health, and Aging, 216 individuals with incident AD were identified and followed longitudinally with in-home visits for a mean of 3.0 years and 2.1 follow-up visits. The Clinical Dementia Rating (CDR) was completed at each follow-up. Medication use was inventoried during in-home visits. Generalized least-squares random-effects regression was performed with CDR Sum of Boxes (CDR-Sum) as the outcome and cardiovascular medication use as the major predictors. RESULTS: CDR-Sum increased an average of 1.69 points annually, indicating a steady decline in functioning. After adjustment for demographic variables and the baseline presence of cardiovascular conditions, use of statins (p = 0.03) and beta-blockers (p = 0.04) was associated with a slower annual rate of increase in CDR-Sum (slower rate of functional decline) of 0.75 and 0.68 points respectively, while diuretic use was associated with a faster rate of increase in CDR-Sum (p = 0.01; 0.96 points annually). Use of calcium-channel blockers, angiotensin-converting enzyme inhibitors, digoxin, or nitrates did not affect the rate of functional decline. CONCLUSIONS: In this population-based study of individuals with incident AD, use of statins and beta-blockers was associated with delay of functional decline. Further studies are needed to confirm these results and to determine whether treatment with these medications may help delay AD progression.

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