Dementia is one of the main causes of illness and death in the world, which already affects more than 55 million people according to the World Health Organization (WHO) and is expected to continue increasing due to the progressive aging of the population. since the available treatments are not curative and have limited effects, which constitutes an enormous challenge for public health and medicine.
Therefore, even a small advance could make a big difference. For example, delaying the onset of Alzheimer’s by five years would reduce its prevalence and associated costs by 40%, in addition to the added healthy life span. Various mechanisms have been identified that intervene in the development of dementia, such as the abnormal accumulation and degradation of proteins, and this opens the possibility of reusing generic medications that act on these pathways.
A team of scientists has carried out new research in which they have reviewed 14 studies and data from more than 130 million patients and have found an association between the use of medications such as vaccines, anti-inflammatories and antibiotics and a lower risk of dementia. Their promising findings have been published in Alzheimer’s and Dementia: Translational Research & Clinical Interventions.
Medications that can help prevent dementia
The researchers explain in the article that their objective was to identify consistent patterns in medications or drug classes that can modify the risk of dementia diagnosis and that their methodology covers all currently prescribed medications, allowing the identification of options that could have been overlooked. overlooked, in order to support the reuse of medications, propose prevention strategies and reduce the risk of dementia in the population.
The study results support the hypothesis that viral or bacterial infections could trigger dementia. The researchers found that 17 medications (such as catecholamine modulators, anticoagulants, anticonvulsants, and antibiotics/antivirals) were associated with a greater than 50% risk reduction. While four vaccines (hepatitis A, typhoid, combined hepatitis A and typhoid, and diphtheria) were related to a lower risk of dementia and Alzheimer’s, with a risk reduction range between 8% and 32%.
Specific medications, such as the antiviral valacyclovir, the anti-inflammatory montelukast and the antihypertensive losartan, showed promising results. Other studies reviewed identified promising medications, including gemfibrozil (to lower triglycerides), ibuprofen (anti-inflammatory), and ceftriaxone (antibiotic). Additionally, vitamins and minerals such as vitamin D, zinc and selenium were also associated with benefits. These findings suggest that some existing treatments could be repurposed to prevent dementia.
Eloy Rodríguez, neurologist at the Marqués de Valdecilla-IDIVAL University Hospital and professor at the University of Cantabria, who has not participated in the study, believes that “these studies are interesting as generators of hypotheses, but conclusions should not be drawn from them, since The data, in general, are of low quality (taken from large registries, with very limited clinical information, and there is not always any) and are subject to finding erroneous relationships (for example, you can associate the use of antidepressants to dementia, but it is actually the early stages of dementia that cause more antidepressants to be prescribed; or treatments for cerebrovascular events, when it is the stroke that predisposes to dementia)”, as he told SMC Spain.
Vaccines could ‘train’ our brain immune system to better fight harmful infectious events or have a more appropriate response to other events that can influence the risk of dementia
“The topic of anti-inflammatories is not new, in fact, clinical studies have been carried out in Alzheimer’s disease with some NSAIDs.” [antiinflamatorio no esteroideo]but without result when looking for the direct relationship. The topic of antimicrobials and vaccines is interesting, since there has been talk for some time about the possible relationship of certain infections, mainly viral, with the etiology of Alzheimer’s disease, and the possible protective action of some vaccines by ‘training’ our brain immune system, either to better fight against these harmful infectious events, or to have a more adequate immune response to other events that may influence the risk of developing the disease,” he adds.
“In short, for me no significant conclusions can be drawn from causal/protective relationships, but it is interesting to maintain the research focus (or increase it) on the role of viral infections and the regulation of immunity/inflammation as factors that participate in the origin of Alzheimer’s disease and other neurodegenerative diseases.
In the opinion of Dr. Richard Oakley, Associate Director of Research and Innovation at the Alzheimer’s Society, and according to his statements to SMC UK, “this research provides some initial basis and indicates which drugs have potential to be repurposed for dementia and should be prioritized for further investigation.”
“But we cannot draw definitive conclusions from this study alone. This is an observational study, so more work is needed to understand the delicate balance between how medications work, their specific doses, interactions with other medications, and the individual’s own health, and how this may affect the risk of a person develops dementia. Clinical trials will help answer some of these questions in the context of dementia,” concludes the expert.
