A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline

Penny A Dacks¹, Joshua J Armstrong², Stephen K Brannan³, Aaron J Carman⁴, Allan M Green⁵, M Sue Kirkman⁶, Lawrence R Krakoff⁷, Lewis H Kuller⁸, Lenore J Launer⁹, Simon Lovestone¹⁰, Elizabeth Merikle³, Peter J Neumann¹¹, Kenneth Rockwood^{2

12

13}, Diana W Shineman⁴, Richard G Stefanacci¹⁴, Priscilla Velentgas¹⁵, Anand Viswanathan¹⁶, Rachel A Whitmer¹⁷, Jeff D Williamson¹⁸, Howard M Fillit⁴

Affiliations

¹ Alzheimer's Drug Discovery Foundation, 57 West 57th St. Suite 901, New York, NY, 10019, USA. pdacks@alzdiscovery.org.
² Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
³ Takeda Pharmaceuticals, Deerfield, IL, USA.
⁴ Alzheimer's Drug Discovery Foundation, 57 West 57th St. Suite 901, New York, NY, 10019, USA.
⁵ Attorney at Law, Cambridge, MA, USA.
⁶ Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
⁷ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁸ Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
⁹ Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD, USA.
¹⁰ Department of Psychiatry, University of Oxford, Oxford, UK.
¹¹ Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
¹² DGI Clinical, Halifax, NS, Canada.
¹³ Nova Scotia Health Authority, Halifax, NS, Canada.
¹⁴ Thomas Jefferson College of Population Health, The Access Group, Philadelphia, PA, USA.
¹⁵ Scientific Affairs, Quintiles Real World Late Phase Research, Cambridge, MA, USA.
¹⁶ Representative for the American Heart Association; Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA, USA.
¹⁷ Kaiser Permanente Division of Research, Population Science and Brain Aging, Oakland, CA, USA.
¹⁸ Wake Forest University School of Medicine, Winston-Salem, NC, USA.

PMID: 27543171
PMCID: PMC4992192
DOI: 10.1186/s13195-016-0200-3

Review

A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline

Penny A Dacks et al. Alzheimers Res Ther. 2016.

. 2016 Aug 20:8:33.

doi: 10.1186/s13195-016-0200-3.

Authors

Affiliations

¹ Alzheimer's Drug Discovery Foundation, 57 West 57th St. Suite 901, New York, NY, 10019, USA. pdacks@alzdiscovery.org.
² Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
³ Takeda Pharmaceuticals, Deerfield, IL, USA.
⁴ Alzheimer's Drug Discovery Foundation, 57 West 57th St. Suite 901, New York, NY, 10019, USA.
⁵ Attorney at Law, Cambridge, MA, USA.
⁶ Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
⁷ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁸ Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
⁹ Intramural Research Program, National Institute on Aging, NIH, Bethesda, MD, USA.
¹⁰ Department of Psychiatry, University of Oxford, Oxford, UK.
¹¹ Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
¹² DGI Clinical, Halifax, NS, Canada.
¹³ Nova Scotia Health Authority, Halifax, NS, Canada.
¹⁴ Thomas Jefferson College of Population Health, The Access Group, Philadelphia, PA, USA.
¹⁵ Scientific Affairs, Quintiles Real World Late Phase Research, Cambridge, MA, USA.
¹⁶ Representative for the American Heart Association; Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA, USA.
¹⁷ Kaiser Permanente Division of Research, Population Science and Brain Aging, Oakland, CA, USA.
¹⁸ Wake Forest University School of Medicine, Winston-Salem, NC, USA.

PMID: 27543171
PMCID: PMC4992192
DOI: 10.1186/s13195-016-0200-3

Abstract

Common diseases like diabetes, hypertension, and atrial fibrillation are probable risk factors for dementia, suggesting that their treatments may influence the risk and rate of cognitive and functional decline. Moreover, specific therapies and medications may affect long-term brain health through mechanisms that are independent of their primary indication. While surgery, benzodiazepines, and anti-cholinergic drugs may accelerate decline or even raise the risk of dementia, other medications act directly on the brain to potentially slow the pathology that underlies Alzheimer's and other dementia. In other words, the functional and cognitive decline in vulnerable patients may be influenced by the choice of treatments for other medical conditions. Despite the importance of these questions, very little research is available. The Alzheimer's Drug Discovery Foundation convened an advisory panel to discuss the existing evidence and to recommend strategies to accelerate the development of comparative effectiveness research on how choices in the clinical care of common chronic diseases may protect from cognitive decline and dementia.

Keywords: Alzheimer’s; Cognitive aging; Cognitive decline; Comorbidity; Comparative effectiveness; Dementia; Diabetes; Hypertension; Prevention; Repurposing.

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References

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A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline

Affiliations

A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous