当前位置： SCI文献检索 > BMJ Open期刊下所有文献 > Effects of centrally acting ACE inhibitors on the rate of cognitive decline in dementia.

Effects of centrally acting ACE inhibitors on the rate of cognitive decline in dementia.

Abstract：

OBJECTIVES:There is growing evidence that antihypertensive agents, particularly centrally acting ACE inhibitors (CACE-Is), which cross the blood-brain barrier, are associated with a reduced rate of cognitive decline. Given this, we compared the rates of cognitive decline in clinic patients with dementia receiving CACE-Is (CACE-I) with those not currently treated with CACE-Is (NoCACE-I), and with those who started CACE-Is, during their first 6 months of treatment (NewCACE-I). DESIGN:Observational case-control study. SETTING:2 university hospital memory clinics. PARTICIPANTS:817 patients diagnosed with Alzheimer's disease, vascular or mixed dementia. Of these, 361 with valid cognitive scores were included for analysis, 85 CACE-I and 276 NoCACE-I. MEASUREMENTS:Patients were included if the baseline and end-point (standardised at 6 months apart) Standardised Mini-Mental State Examination (SMMSE) or Quick Mild Cognitive Impairment (Qmci) scores were available. Patients with comorbid depression or other dementia subtypes were excluded. The average 6-month rates of change in scores were compared between CACE-I, NoCACE-I and NewCACE-I patients. RESULTS:When the rate of decline was compared between groups, there was a significant difference in the median, 6-month rate of decline in Qmci scores between CACE-I (1.8 points) and NoCACE-I (2.1 points) patients (p=0.049), with similar, non-significant changes in SMMSE. Median SMMSE scores improved by 1.2 points in the first 6 months of CACE treatment (NewCACE-I), compared to a 0.8 point decline for the CACE-I (p=0.003) group and a 1 point decline for the NoCACE-I (p=0.001) group over the same period. Multivariate analysis, controlling for baseline characteristics, showed significant differences in the rates of decline, in SMMSE, between the three groups, p=0.002. CONCLUSIONS:Cognitive scores may improve in the first 6 months after CACE-I treatment and use of CACE-Is is associated with a reduced rate of cognitive decline in patients with dementia.

journal_name

BMJ Open

journal_title

BMJ open

authors

Gao Y,O'Caoimh R,Healy L,Kerins DM,Eustace J,Guyatt G,Sammon D,Molloy DW

doi

10.1136/bmjopen-2013-002881

subject

Has Abstract

pub_date

2013-07-25 00:00:00

issue

7

issn

2044-6055

pii

bmjopen-2013-002881

journal_volume

3

pub_type

杂志文章

相关文献

BMJ Open文献大全