X-Message-Number: 14455
Date: Tue, 12 Sep 2000 13:34:54 -0700 (PDT)
From: Doug Skrecky <>
Subject: diuretics slow the progression of dementia

Title
  Occurrence and progression of
  dementia in a community population aged 75 years and older:
  relationship of antihypertensive medication use.
Source
  Archives of Neurology.  56(8):991-6, 1999 Aug.
Abstract
  OBJECTIVE: To examine whether antihypertensive medication use can affect the
  occurrence and progression of
  dementia. SUBJECTS AND METHODS: In a community cohort of
  1810 persons aged 75 years and older, 225 prevalent cases of
  dementia were detected. Among the 1301 persons without
  dementia, 224 incident cases of dementia
  were identified during an average period of 3 years. Among the 225 prevalent
  cases of dementia, 79 were suitable for the analysis of
  cognitive decline. Information on drug use was collected for the 2 weeks
  preceding the baseline interview. RESULTS: Subjects taking antihypertensive
  medication (n = 651, 83.9% of whom took diuretics) had a lower prevalence of
  dementia than those not taking antihypertensive medication
  (P<.001). Subjects without dementia who were taking
  antihypertensive medication at baseline (n = 584) had a reduced incidence of
  dementia (adjusted relative risk, 0.7; 95% confidence
  interval, 0.6-1.0; P = .03). Furthermore, subjects taking diuretics (n = 484)
  had an adjusted relative risk of 0.7 (95% confidence interval, 0.5-1.0; P =
  .02) for all dementia, and subjects taking diuretic
  monotherapy (n = 345) had an adjusted relative risk of 0.6 (95% confidence
  interval, 0.4-0.9; P = .006). The use of other antihypertensive medication
  (calcium antagonists or beta-blockers), however, was related to a reduced
  risk of Alzheimer disease (adjusted relative risk, 0.6; 95% confidence
  interval, 0.3-1.2) only in the subpopulation with a higher baseline blood
  pressure (n = 458). Patients with dementia at baseline who
  were not taking diuretics had a 2-fold faster rate of decline in the score on
  the Mini-Mental State Examination than those taking diuretics. CONCLUSION:
  The use of diuretics may protect against dementia in elderly
  persons.

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