Popular Erectile Dysfunction Meds May Cut Risk of Alzheimer’s Disease
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A large new study involving more than a quarter million men with erectile dysfunction (ED) suggests that common medications for this problem might be repurposed to help prevent Alzheimer’s disease.
“The findings cautiously allude to greater benefit from PDE5I use in individuals at greatest risk of Alzheimer’s disease — for example, men 70 years and older,” says a author of the research, Ruth Brauer, PhD, an instructor in pharmacology and epidemiology at University College London.
Men Taking ED Treatment Were Less Likely to Develop Dementia
Dr. Brauer and her collaborators based their results on analysis of electronic health records representing about 270,000 men age 40 and older who had a new diagnosis of erectile dysfunction between 2000 and 2017. Participants didn’t have cognitive impairment at the start of the study, but during an average follow-up period of five years, 1,119 were diagnosed with Alzheimer’s dementia.
Among the participants taking erectile dysfunction drugs, 749 developed Alzheimer’s disease, which corresponds to a rate of 8.1 cases per 10,000 person-years. (Person-years represent both the number of people in the study and the amount of time each individual spends in the study.) Among those who did not take the drugs, 370 developed Alzheimer’s disease, corresponding to a rate of 9.7 cases per 10,000 person-years.
Researchers calculated the percentage risk difference between the two groups after adjusting for other factors that could affect the rate of Alzheimer’s disease, such as age, smoking status, and alcohol consumption.
The paper highlighted that the association with Alzheimer’s risk reduction was strongest in those who were issued the most prescriptions over the study period.
Repurposing Medications in the Fight Against Alzheimer’s
While these therapies have shown great promise, there continues to be a need for affordable treatments that can safely reduce the risk of Alzheimer’s.
“Although we’re making progress with the new treatments for Alzheimer’s disease that work to clear amyloid plaques in the brain for people with early stages of the disease, we desperately need treatments that can prevent or delay the development of Alzheimer’s disease,” says Brauer.
“This is another well-designed study suggesting that [PDE5Is] could help reduce the risk of Alzheimer’s disease,” says Glen Finney, MD, the director of the memory and cognition program at Geisinger Health in Wilkes-Barre, Pennsylvania, and a fellow of the American Academy of Neurology. “This class of medication is more famous for being used in erectile dysfunction, but has other medical uses as well.”
Why PDE5Is Might Lower Dementia Risk
Because these medications stimulate blood flow, some scientists have speculated that they could influence blood circulation in the brain and provide some protection against dementia as well.
“The relaxation of blood vessels has been shown in animal models to extend to the brain and result in increased cerebral blood flow, which can be neuroprotective,” says Brauer.
More Research and Clinical Trials Are Needed
Brauer and her coauthors stress that their results do not prove that erectile dysfunction drugs reduce the risk of Alzheimer’s disease; they only show an association.
Dr. Finney, who was not involved in this latest study, says that well-designed clinical trials, with a treatment and a placebo group, are needed to come to more definitive conclusions.
“Over the decades we’ve seen several retrospective studies suggest a potential prevention or treatment for Alzheimer’s disease, but that didn’t hold up in the gold standard of clinical trials,” he says. “So that is vitally important to really see the promise of this class of medication in the fight against Alzheimer’s disease and related disorders.”
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