title: Angiotensin converting enzyme inhibitors and cognitive and functional decline in patients with Alzheimer's disease: an observational study.
abstract: We previously reported that angiotensin converting enzyme inhibitors (ACEIs) decrease the rate of cognitive decline in elderly patients with hypertension, but their impact on patients with Alzheimer's disease (AD) is not known. A total of 62 elderly patients with AD were enrolled, and 52 completed the study for 6 months. Mini-Mental Status Examination (MMSE), Clock Draw Test (CDT), working memory (Digit Ordering), Instrumental Activities of Daily Living (IADL) scale, and the Screen for Caregiver Burden (SCB) were collected at baseline, 3 months, and 6 months. AD patients receiving ACEI (N = 15) demonstrated a slower rate of decline in digit forward (P = .003) and IADL scale (P = .003) and an improved measure of caregiver burden (P = .04) but not MMSE (P =.15) or CDT (P =.9) compared with those not receiving ACEI after adjusting for other risk factors. This study suggests that use of ACEI in AD patients is associated with slower rate of AD progression. A randomized clinical trial is needed to confirm our finding.
authors.affiliation: Institute for Aging Research/Hebrew SeniorLife, Harvard Medical School, and the Beth Israel Deconess Medical Center, Boston, Massachusetts 02131, USA. ihabhajjar@hrca.harvard.edu
authors.forename: Ihab M
authors.initials: IM
authors.lastname: Hajjar
authors.forename: Michelle
authors.initials: M
authors.lastname: Keown
authors.forename: Paige
authors.initials: P
authors.lastname: Lewis
authors.forename: Amit
authors.initials: A
authors.lastname: Almor
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015588:Observer Variation; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors