Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA.
Price School of Public Policy, University of Southern California, Los Angeles, California, USA.
Alzheimers Dement. 2021 Jan;17(1):41-48. doi: 10.1002/alz.12175. Epub 2020 Oct 8.
Most older Americans use drug therapies for chronic conditions. Several are associated with risk of Alzheimer's disease and related dementias (ADRD).
A scoping review was used to identify drug classes associated with increasing or decreasing ADRD risk. We analyzed size, type, and findings of the evidence.
We identified 29 drug classes across 11 therapeutic areas, and 404 human studies. Most common were studies on drugs for hypertension (93) or hyperlipidemia (81). Fewer than five studies were identified for several anti-diabetic and anti-inflammatory drugs. Evidence was observational only for beta blockers, proton pump inhibitors, benzodiazepines, and disease-modifying anti-rheumatic drugs. For 13 drug classes, 50% or more of the studies reported consistent direction of effect on risk of ADRD.
Future research targeting drug classes with limited/non-robust evidence, examining sex, racial heterogeneity, and separating classes by molecule, will facilitate understanding of associated risk, and inform clinical and policy efforts to alleviate the growing impact of ADRD.
大多数美国老年人使用药物疗法来治疗慢性疾病。其中一些与阿尔茨海默病和相关痴呆症（ADRD）的风险有关。
本研究采用范围综述来确定与增加或降低 ADRD 风险相关的药物类别。我们分析了证据的规模、类型和结果。
我们确定了 11 个治疗领域的 29 种药物类别和 404 项人体研究。最常见的是关于高血压（93 项）或高血脂（81 项）药物的研究。针对几种抗糖尿病和抗炎药物的研究少于五项。只有观察性证据表明β受体阻滞剂、质子泵抑制剂、苯二氮䓬类药物和疾病修饰抗风湿药物与 ADRD 风险有关。对于 13 种药物类别，超过 50%的研究报告了对 ADRD 风险的一致影响方向。
未来针对证据有限/不稳健的药物类别的研究，检查性别、种族异质性，并按分子对药物类别进行分类，将有助于了解相关风险，并为临床和政策努力提供信息，以减轻 ADRD 日益增长的影响。
