Key result
Oral anticoagulants, particularly direct oral anticoagulants, were associated with a markedly decreased incidence of composite dementia in patients with atrial fibrillation.
Why the study?
The co-development of Alzheimer's disease and cardiovascular disease, along with underlying molecular mechanisms, is not well understood.
Do oral anticoagulants reduce the incidence of dementia and Alzheimer's disease in patients with atrial fibrillation?
Do oral anticoagulants reduce the incidence of dementia and Alzheimer's disease in patients with atrial fibrillation?
Answers are grounded in this paper and cite their sources.
Oral anticoagulants, particularly direct oral anticoagulants, may reduce the incidence of dementia in patients with atrial fibrillation, highlighting a potential preventive approach for Alzheimer's disease.
Alzheimer's disease (AD) and cardiovascular disease (CVD) are strongly associated. Both are multifactorial disorders with long asymptomatic phases and similar risk factors. Indeed, CVD signatures such as cerebral microbleeds, micro-infarcts, atherosclerosis, cerebral amyloid angiopathy and a procoagulant state are highly associated with AD. However, AD and CVD co-development and the molecular mechanisms underlying such associations are not understood. Here, we review the evidence regarding the vascular component of AD and clinical studies using anticoagulants that specifically evaluated the development of AD and other dementias. Most studies reported a markedly decreased incidence of composite dementia in anticoagulated patients with atrial fibrillation, with the highest benefit for direct oral anticoagulants. However, sub-analyses by differential dementia diagnosis were scarce and inconclusive. We finally discuss whether anticoagulation could be a plausible preventive/therapeutic approach for AD and, if so, which would be the best drug and strategy to maximize clinical benefit and minimize potential risks. LINKED ARTICLES: This article is part of a themed issue From Alzheimer's Disease to Vascular Dementia: Different Roads Leading to Cognitive Decline. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.6/issuetoc.
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Toribio‐Fernández et al. (2023) conducted a review in Alzheimer's disease. Oral anticoagulants was evaluated. Oral anticoagulants, particularly direct oral anticoagulants, were associated with a markedly decreased incidence of composite dementia in patients with atrial fibrillation.
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