title: Diuretic use is associated with better learning and memory in older adults in the Ginkgo Evaluation of Memory Study.
abstract: BACKGROUND
  To investigate the association between diuretics, angiotensin-converting enzyme inhibitors (ACE-I), angiotensin II receptor blockers (AT2RB), and cognitive function.
  
  
  METHODS
  This post hoc analysis of the randomized controlled Ginkgo Evaluation of Memory Study trial focuses on 3069 nondemented community-dwelling participants aged >75 years. At baseline visit, detailed information about medication use was collected and five cognitive domains were assessed. Multivariate linear regression analyses were used to assess cross-sectional associations between medication use and cognitive function.
  
  
  RESULTS
  In all, 36% of participants reported history of hypertension and 53% reported antihypertensive medication use, with 17% reporting diuretic, 11% ACE-I, and 2% AT2RB use. Potassium-sparing diuretic use (N = 192) was associated with better verbal learning and memory measured by California Verbal Learning Test as compared with no antihypertensive medication users (β = 0.068, P = .01; β = 0.094, P < .001) and other antihypertensive medication users (β = 0.080, P = .03; β = 0.153, P < .001). Use of ACE-I or AT2RB was not associated with better cognitive function.
  
  
  CONCLUSIONS
  Results warrant further investigation into possible protective effects of potassium-sparing diuretics and the role of potassium in mitigating cognitive decline.
authors.affiliation: Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. syasar1@jhmi.edu
authors.forename: Sevil
authors.initials: S
authors.lastname: Yasar
authors.forename: Fu-Mei
authors.initials: FM
authors.lastname: Lin
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.forename: Claudia H
authors.initials: CH
authors.lastname: Kawas
authors.forename: Kaycee M
authors.initials: KM
authors.lastname: Sink
authors.forename: Steven T
authors.initials: ST
authors.lastname: DeKosky
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Carlson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D003704:Dementia / Q000517:prevention & control*; D004232:Diuretics / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D020441:Ginkgo biloba; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007858:Learning / Q000187:drug effects*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000187:drug effects*; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D008517:Phytotherapy / Q000379:methods*; D012111:Residence Characteristics; D016896:Treatment Outcome
chemical_list: D057911:Angiotensin Receptor Antagonists; D004232:Diuretics