The Use of Angiotensin-converting Enzyme Inhibitors and Diuretics Is Associated With a Reduced Incidence of Impairment on Cognition in Elderly Women

The effects of angiotensin-converting enzyme inhibitors (ACE-Is) and diuretics (used as antihypertensive agents) on global and domain-specific cognitive decline were evaluated in 326 non-demented community-dwelling participants over the age of 70 years in the Women's Health and Aging Study II. Time-dependent Cox proportional hazards regression analysis was used for evaluating the association between parameters. The use of ACE-I for more than 3 years was associated with reduced incidence of impairment on Mini-Mental State Examination (MMSE), Trail Making Test-Part A and Part B (TMT, Parts A and B), Hopkins Verbal Learning Test-Immediate Recall (HVLT-I), and Hopkins Verbal Learning Test-Delayed Recall (HVLT-D). The use of diuretics for more than 3 years was associated with reduced incidence of impairment on MMSE, TMT, Parts A and B, HVLT-I, and (HVLT-D). The presence of vascular disease did not make any difference to these effects. Therefore, the use of ACE-Is or diuretics was associated with reduced incidence of impairment of both global and domain-specific cognition in elderly women, and may help delay progression to dementia.