Sharma Niti, An Seong Soo A, Kim Sang Yun
Bionano Research Institute, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si 13120, Republic of Korea.
Department of Neurology, Seoul National University Bundang Hospital & Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si 13620, Republic of Korea.
Int J Mol Sci. 2024 Nov 29;25(23):12850. doi: 10.3390/ijms252312850.
Alzheimer's disease (AD), a complex neurodegenerative disease (ND), is the most predominant cause of dementia among the elderly. Generally, elderly people have multiple chronic health conditions, like hypertension, arthritis, diabetes, insomnia, bowel problems, and depression. Although prescribed medications have beneficial therapeutic compositions, some may have side effects that could hinder cognitive function or worsen cognitive decline. Hence, we should evaluate those medications to guarantee their safety. In the present mechanistic review, we discussed frequently used categories of medication (analgesics, anticholinergics, benzodiazepines, proton pump inhibitors, and statins), concerning their possible involvement in increasing AD and dementia risks. This review summarized the results of various observational studies, meta-analyses, randomized case-control studies, and systematic reviews. As the results were contradictory, it was difficult to ascertain the clear associations between medication usage and increased risks of dementia or AD. The blood-based biomarkers (BBMs) offer a low-cost and accessible alternative for early diagnosis of AD. Systematic reviews combined with meta-analysis would be crucial tools for accurately assessing and summarizing the efficacy of health interventions, yet randomized clinical trials have always been the best way to help with clinical care decisions. Thus, an open discussion is necessary to help individuals determine whether the advantages of utilizing medications outweigh the possible drawbacks.
阿尔茨海默病（AD）是一种复杂的神经退行性疾病（ND），是老年人痴呆最主要的病因。一般来说，老年人患有多种慢性健康问题，如高血压、关节炎、糖尿病、失眠、肠道问题和抑郁症。尽管处方药具有有益的治疗成分，但有些可能有副作用，可能会阻碍认知功能或使认知衰退恶化。因此，我们应该评估这些药物以确保其安全性。在本机制综述中，我们讨论了常用药物类别（镇痛药、抗胆碱能药、苯二氮䓬类药物、质子泵抑制剂和他汀类药物），涉及其可能增加患AD和痴呆风险的情况。本综述总结了各种观察性研究、荟萃分析、随机病例对照研究和系统评价的结果。由于结果相互矛盾，很难确定药物使用与痴呆或AD风险增加之间的明确关联。基于血液的生物标志物（BBM）为AD的早期诊断提供了一种低成本且易于获得的替代方法。系统评价结合荟萃分析将是准确评估和总结健康干预措施疗效的关键工具，但随机临床试验一直是帮助做出临床护理决策的最佳方式。因此，有必要进行公开讨论，以帮助个人确定使用药物的益处是否超过可能的弊端。
