Blog | Friday, July 26, 2013

QD: News Every Day--ACE inhibitors may slow cognitive decline of dementia

ACE inhibitors may slow the rate of cognitive decline typical of dementia, a small study found.

Researchers at two university centers in Ireland compared the rates of cognitive decline in 361 patients who had either been diagnosed with Alzheimer's disease, vascular dementia or a mix of both from 1999 to 2010. Eighty five of the patients were already taking ACE inhibitors. Cognitive decline was assessed using either the Standardized Mini Mental State Examination (SMMSE) or the Quick Mild Cognitive Impairment (Qmci) screen.

Results appeared online at BMJ Open

There was a significant difference in the median, 6-month rate of decline in Qmci scores between those taking ACE inhibitors and those not taking them (1.8 points vs. 2.1 points; P=0.049).

The researchers also assessed the impact of ACE inhibitors on the brain power of 30 patients newly prescribed these drugs during their first six months of treatment.

Median SMMSE scores improved by 1.2 points in the first 6 months of newly taking ACE inhibitors, compared to a 0.8 point decline for the group already receiving them (P=0.003) group and a 1 point decline for the group not taking them (P=0.001) group over the same period.

Researchers noted that the results may results from better adherence to the medication regimen, better blood pressure control, or improved blood flow to the brain.

"This [study] supports the growing body of evidence for the use of ACE inhibitors and other [blood pressure lowering] agents in the management of dementia," the authors wrote. "Although the differences were small and of uncertain clinical significance, if sustained over years, the compounding effects may well have significant clinical benefits."