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Angiotensin-Converting Enzyme Inhibitors and Alzheimer's Disease Progression in Older Adults: Results from the Réseau sur la Maladie d'Alzheimer Français Cohort.
- Source :
-
Journal of the American Geriatrics Society . Sep2013, Vol. 61 Issue 9, p1482-1488. 7p. 1 Diagram, 2 Charts, 1 Graph. - Publication Year :
- 2013
-
Abstract
- Objectives To assess whether angiotensin-converting enzyme inhibitor ( ACE-I) treatment is associated with less cognitive decline in older adults with Alzheimer's disease ( AD) than in those using other hypertensive or no drugs. Design Four-year prospective multicenter cohort study with a biannual assessment. Setting Memory clinics from 16 university hospitals in France. Participants Community-dwelling older adults with mild to moderate AD (N = 616). Measurements Participants were stratified into four groups according to type and duration of antihypertensive drug treatment. Cognitive decline was assessed using the Mini-Mental State Examination ( MMSE). Linear mixed-effects models were used to assess differences in decline in MMSE score between the four groups. Hypertension at each visit was included in the model. Results Sixty-one participants had used ACE-Is continuously, 57 had used them intermittently, 189 had used other antihypertensive drugs, and 309 never used any antihypertensive drugs. Continuous ACE-Is users had a 4-year decline in MMSE of 6.4 ± 1.6 points ( P < .001), intermittent ACE-Is users of 7.9 ± 1.1 points ( P < .001), continuous or intermittent users of other antihypertensive drugs of 8.8 ± 0.7 points ( P < .001), and never-users of 10.2 ± 0.6 points ( P < .001). MMSE decline between the four groups was significantly different (adjusted P = .02). In subgroup analysis, the 118 (19.2%) participants who had continuously or intermittently used ACE-Is had a significant difference in 4-year MMSE decline from the 498 (80.8%) who had never used ACE-Is (7.5 ± 0.9 vs 9.7 ± 0.4; P = .03). Conclusion The use of ACE-Is in older adults with AD is associated with a slower rate of cognitive decline independent of hypertension. Future research is needed to explore the role of ACE-Is in long-term AD progression. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ACE inhibitors
*ANTIHYPERTENSIVE agents
*ACADEMIC medical centers
*ALZHEIMER'S disease
*CHI-squared test
*FISHER exact test
*HYPERTENSION
*LONGITUDINAL method
*NEUROPSYCHOLOGICAL tests
*MEDICAL cooperation
*HEALTH outcome assessment
*RESEARCH
*RESEARCH funding
*STATISTICS
*SECONDARY analysis
*TREATMENT effectiveness
*DISEASE progression
*DATA analysis software
*DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 00028614
- Volume :
- 61
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 90180593
- Full Text :
- https://doi.org/10.1111/jgs.12415