Older adults who took medications for high blood pressure, high cholesterol and diabetes had slower rates of cognitive decline over a nine-year period than others, according to an observational study of 4,651 older adults. The median age of participants was 77.
“Persons who were on two or three medication classes performed as if they were cognitively three years younger,” says Roshni Biswas, a research scientist at the Rush Alzheimer’s Disease Center, who presented the study July 27 at the Alzheimer’s Association International Conference in Toronto. “The cognitive change in someone who was 80 and on three medication classes was similar to the cognitive change in someone who was 77 and on none of the studied medication classes.”
The results don’t offer concrete advice. Although an observational study can show whether two things are related, it is not able to prove cause and effect, says Mitchell S. V. Elkind, M.D., chief science officer for brain health and stroke at the American Heart Association.
Treating modifiable risk factors
Doctors have long known that high blood pressure, high LDL cholesterol (the bad type of cholesterol) and diabetes increase the risk of dementia. A recent clinical trial from China found that taking medication to lower blood pressure for as little as four years can reduce the risk of dementia by 15 percent.
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Another trial from the United States found that study participants randomly assigned to take medication to aggressively lower their blood pressure reduced their risk of mild cognitive impairment or probable dementia by 11 percent more than participants who reduced their blood pressure by a smaller amount.
The Lancet Commission last year concluded that about 45 percent of all cases of dementia are potentially preventable if people address 14 modifiable risk factors throughout their lives.
Those risk factors also include vision loss, hearing loss, smoking, obesity, depression, physical inactivity, excessive alcohol consumption, traumatic brain injury, air pollution, lack of education and social isolation.
High blood pressure, diabetes and high cholesterol damage blood vessels, including vessels that lead to the brain or are in the brain itself, says Glenn Herrington, a cardiology clinical pharmacist practitioner at Novant Health Heart & Vascular Institute in Wilmington, North Carolina.