Effects of cardiovascular medications on rate of functional decline in Alzheimer disease.
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.
Rosenberg
P B
PB
Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. prosenb9@jhmi.edu
Mielke
M M
MM
Tschanz
J
J
Cook
L
L
Corcoran
Chris
C
Hayden
K M
KM
Norton
M
M
Rabins
P V
PV
Green
R C
RC
Welsh-Bohmer
K A
KA
Breitner
J C S
JC
Munger
R
R
Lyketsos
C G
CG
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000517:prevention & control / Q000523:psychology*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D015331:Cohort Studies; D003704:Dementia / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index
D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors