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Preserved cognition and reduced age-related cognitive decline during treatment with angiotensin II receptor blockers: A 20-year follow-up study

Published online by Cambridge University Press:  23 March 2020

D. Wincewicz ,
T. Tolmunen ,
A.K. Brem ,
J. Kauhanen  and
S. Lehto
D. Wincewicz
Affiliation:
Medical University of Bialystok, Department of Clinical Pharmacology, Bialystok, Poland Medical University of Bialystok, Department of Psychiatry, Bialystok, Poland
T. Tolmunen
Affiliation:
University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland University of Eastern Finland, Department of Psychiatry, Kuopio, Finland
A.K. Brem
Affiliation:
Max Planck Institute of Psychiatry, Department of Neuropsychology, Munich, Germany BIDMC Harvard Medical School, Berenson–Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Boston, USA University of Oxford, Department of Experimental Psychology, Oxford, United Kingdom
J. Kauhanen
Affiliation:
University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
S. Lehto
Affiliation:
University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland University of Eastern Finland, Department of Psychiatry, Kuopio, Finland

Abstract

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Introduction

Modulators of the brain renin-angiotensin system (RAS) have been shown to improve cognitive functioning in several animal models of neuropsychiatric disorders. Moreover, the brain RAS has been considered a new target for the treatment of Alzheimer's disease (AD). However, there are no population-based follow-up studies supporting this hypothesis.

Objectives

Cross-sectional and prospective relationships between cognitive decline and ARB treatment were examined in the population-based Kuopio Ischemic Heart Disease Risk Factor Study.

Aims

To evaluate procognitive/antidementia capacity of orally delivered angiotensin II receptor blockers (ARB).

Methods

The study was conducted on a sample of 1774 subjects (920 females, 854 males; age range at baseline: 42–61 years) from Eastern Finland. An established cutoff score of at least 2-point decrease in the Mini Mental State Examination over a 9-year follow-up was used to detect age-related cognitive decline in the cross-sectional setting. In the prospective setting, a hospital discharge diagnosis of dementia/AD was used as outcome variable. Cross-sectional relationships were determined with logistic regression and prospective analyses were conducted with the Cox proportional hazards model (both adjusted for relevant background variables).

Results

Cross-sectional analysis displayed a decrease of the odds of cognitive decline (n = 87; 4.9% of participants) in those with ARB treatment; OR = 0.445, 95% CI: 0.22–0.90, P = 0.024. Furthermore, in the prospective setting, the risk of dementia/AD diagnosis (n = 149; 8.4% of participants) was significantly reduced in ARB treated participants; HR = 0.621, 95% CI: 0.40–0.98, P = 0.038.

Conclusions

ARB treatment is associated with a decreased risk for age-related cognitive decline and dementia/AD manifestation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Psychopharmacology and pharmacoeconomics and psychoneuroimmunology
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S372
Copyright
Copyright © European Psychiatric Association 2017
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