Blood pressure drugs could reduce the risk of dementia

American researchers investigated the incidence of dementia in 800,000 people aged 65 or over with cardiovascular disease, mostly male. The patients were divided into 3 groups according to the type of blood pressure drugs they were taking : ARBs, lisinopril or other cardiovascular drugs.

The researchers found that ARBs were associated with reduced risk of developing dementia when compared with the other 2 types of drugs. ARBs had additional effects when combined with another type of high BP drug. Those with existing dementia who took both drugs were less likely to die early or be admitted to a nursing home. The study concluded that ARBs could reduce the risk of developing Alzheimer's disease or dementia.

Citics say that there are limitations which may have affected the results: the subjects were not randomly assigned a treatment, each group of people might have different diseases such as diabetes or cardiovascular disease and the follow-up period was too short for a condition such as dementia. Further work is needed to include both male and female.

Source: N-C Li, Lee A, Whitmer RA, et al. "Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis". BMJ 2010; 340: b5465

Regular use of painkillers could cut Alzheimer's risk

A few newspapers reported a study that has found regular use of ibuprofen, aspirin and other painkillers known as NSAIDs reduces the risk of developing the Alzheimer's disease. Doctors warn that people should not take over-the-counter pain remedies to ward off dementia as there are side effects. The finding is based on a review of six studies involved almost 14,000 people.

Researchers concluded that NSAID use reduced the risk of Alzheimer’s disease. However, they did not find that a sub-group of NSAIDs, known as the SALAs, more effective than other non-SALAs in preventing the disease. This suggests that all conventional NSAIDs have a similar protective effect in humans.

Critics say this was a review of selected studies and that the risk from bleeding need to be considered against any benefits.

Source: "No advantage of A 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies." Neurology 2008; May 28 [Epub ahead of print]

Obesity increases dementia risk

Multiple news sources reported a systematic review of 10 published studies in 5 different countries that found obesity increases the risk of dementia in general by 42% and Alzheimer's by 80%. Researchers also found that people who are underweight have an elevated risk of dementia and its subtype. The study also included a meta-analysis of 7 stuides with at least 5 years followed up.

The senior author said that preventing obesity at a younger age could reduce the number of dementia patients in the US.

Source: "Obesity and central obesity as risk factors for incident dementia and its subtypes: a systematic review and meta-analysis". Obesity Reviews 9(3):204-218, May 2008

Anti-psychotic drugs can significantly harm dementia patients

Professor Clive Ballard, one of the world's leading experts in dementia, investigated the effects of the anti-psychotic drugs on dementia patients with shocking results.

His study, featured in the BBC Panorama : Please look after Dad, shows that anti-psychotic medication is given to many dementia patients in care homes in the UK costing £80m per year. He said that these drugs have no benefit to dementia patients and can significantly harm them and called for better care for dementia sufferers without relying on these drugs.

An article "Prescription Abuse Seen In U.S. Nursing Homes" in Wall Street Journal (WSJ) reported similar trend in the use of anti-psychotic drugs in nursing homes prescribed by doctors on dementia sufferers whether they are psychotic or not. Health regulators and patient advocates are questioning such practice.

Healthy diet may cut dementia risk

A study that looked at the diets of more than 8,000 healthy men and women aged over 65 over 4 year period, found that diets rich in fish, omega-3 oils and eating fruit and vegetables daily may decrease the risk of dementia and Alzheimer disease. The study, published in the Journal of Neurology.


Source : "Dietary patterns and risk of dementia -The Three-City cohort study" Neurology 2007;69:1921-1930 (Abstract only)

Oscar the cat and the dying patients

This Thursday issue of the NEJM publishes an unusual article about the story of Oscar the cat that "has an uncanny ability to predict when residents are about to die", written by Dr. Dosa, a Rhode Island Hospital geriatrician and Brown University professor.


Oscar, the 2-year old cat, was adopted as a kitten and grew up in the advanced dementia unit at a nursing and rehabititation center where Dr Dosa works. After 6 months, the staff noticed that Oscar would make ward rounds, sniffing and observing patients. He seems to have the sense about when patients are about to die and would sit beside them when the time is near.


He has predicted 25 cases by curling next to the patients during their final hours, his presence has alerted staff to contact patients' family about the end-of-life stage and most families are grateful for the warning. However, Oscar's ability of sensing the impending death remains a mystery and no one knows if his behaviour is scientifically significant.


Read the free full text article "A Day in the Life of Oscar the Cat" in NEJM, 2007, July 26, Volume 357:328-329