Taguchi Akihiko, Takata Yu, Ihara Masafumi, Kasahara Yukiko, Tsuji Masahiro, Nishino Madoka, Stern David, Okada Masahiro
Department of Regenerative Medicine Research, Institute of Biomedical Research and Innovation, Kobe, Japan.
Psychogeriatrics. 2013 Sep;13(3):164-9. doi: 10.1111/psyg.12021. Epub 2013 Jun 11.
Cerebral ischemia and accumulation of amyloid β (Aβ) are major risk factors for the development of dementia, including vascular dementia and Alzheimer's disease. Cilostazol, an antiplatelet drug, has been shown to improve cerebral circulation and reduce accumulation of Aβ. In this study, the long-term effect of cilostazol on cognitive function was investigated retrospectively.
Medical records at Sumotoitsuki Hospital were surveyed to find all patients treated with cilostazol and evaluated by the Mini-Mental State Examination (MMSE) during at least two visits separated by an interval of more than 6 months. Patients receiving anti-dementia drugs were excluded. Temporal changes in MMSE scores were compared between patients treated with cilostazol (n = 70) and those who ceased administration of this drug (n = 22). The mean follow-up period was 691 days.
Decrease in MMSE score was significantly ameliorated by administration of cilostazol. Subgroup analysis revealed that cilostazol significantly improved MMSE score in patients with mild cognitive impairment, though no significant effect was observed in patients with normal cognitive function or dementia.
Although there are limitations to such a retrospective study, these results significantly encourage undertaking a prospective cohort study to determine the effect of cilostazol on mild cognitive impairment where no treatments currently exist.
脑缺血和β淀粉样蛋白(Aβ)的积累是包括血管性痴呆和阿尔茨海默病在内的痴呆症发展的主要危险因素。西洛他唑是一种抗血小板药物,已被证明可改善脑循环并减少Aβ的积累。在本研究中,对西洛他唑对认知功能的长期影响进行了回顾性研究。
对Sumotoitsuki医院的病历进行调查,以找出所有接受西洛他唑治疗并在至少两次间隔超过6个月的就诊期间通过简易精神状态检查表(MMSE)进行评估的患者。排除接受抗痴呆药物治疗的患者。比较接受西洛他唑治疗的患者(n = 70)和停止使用该药物的患者(n = 22)的MMSE评分随时间的变化。平均随访期为691天。
服用西洛他唑可显著改善MMSE评分的下降。亚组分析显示,西洛他唑可显著改善轻度认知障碍患者的MMSE评分,而在认知功能正常或痴呆的患者中未观察到显著效果。
尽管此类回顾性研究存在局限性,但这些结果显著鼓励开展一项前瞻性队列研究,以确定西洛他唑对目前尚无治疗方法的轻度认知障碍的影响。