Can antibiotics, vaccines, and antivirals help lower dementia risk?
A recent systematic review found that anti-inflammatory medications such as ibuprofen, as well as antibiotics, antiviral drugs, and vaccines, were linked to a lower risk of dementia. Up to 70% of those with dementia have Alzheimer’s disease, and the condition affects over 55 million people globally at an estimated cost of over $1 trillion. Before drawing any conclusions about repurposing current medications for the treatment of dementia, experts point out that more research is necessary due to the complexity of dementia in various individuals. In a recent systematic review, researchers from the Universities of Cambridge and Exeter in the United Kingdom found that anti-inflammatory drugs like ibuprofen, antibiotics, antiviral drugs, and vaccines, were linked to a lower risk of dementia.
Published in Alzheimer’s and Dementia: Translational Research and Clinical Interventions, the review examined data from 14 studies that included 1 million dementia cases and over 130 million people. Antimicrobials, vaccinations, and anti-inflammatory drugs (NSAIDs) were linked to a lower risk of dementia. In contrast, vitamins, supplements, antipsychotics, and diabetes medications were somewhat linked to a higher risk, according to the researchers’ analysis of medical and administrative records as well as large clinical datasets. Evidence regarding antidepressants and certain blood pressure medications was inconclusive. The authors observed that overall, there was a lack of consistency across studies in identifying specific medications that alter the risk of Alzheimer’s disease or all-cause dementia and that some limitations and false positives may have impacted findings.
It’s crucial to keep in mind that dementia, which merely characterizes a collection of progressive symptoms, can result from a variety of pathological conditions. Furthermore, according to Dr. Dot MacSweeney, Alzheimer’s disease, the most prevalent cause of dementia as we age, is not a single illness. It is complicated and has a lot of aberrant biomarkers. However, it is widely acknowledged that the majority of conditions that eventually lead to dementia do, in large part, have a neuroinflammatory origin, just like many other diseases. Large-scale, longitudinal, randomized controlled trials (RCTs) are required to prove a causal relationship between dementia risk and particular medications, according to MacSweeney.
Confounding variables such as age, gender, and comorbidities should be controlled for, and lifestyle and genetic data should be included to find effects specific to subgroups, and biomarkers (e.g. G. levels of tau or amyloid) to gauge how drugs affect the body. She also suggested that they concentrate on long-term results to verify a lower incidence of dementia. Given how common these drugs are already worldwide, Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the review, expressed some skepticism to MNT regarding its findings: Studies frequently surface expressing concern for prescription and over-the-counter medications causing dementia that are not clinically observed. For instance, studies have shown that taking allergy drugs like Benadryl/diphenhydramine increases the risk of dementia; however, in my clinical neurology practice, I have never observed this to be the case.
Although sleep aids are frequently linked to deteriorating memory loss in the elderly, I think the advantages of getting a good night’s sleep exceed any possible hazards. According to him, there are too many cooks in the kitchen these days, and if dementia is a concern, you should speak with a specialist like me who makes it their career to diagnose and treat dementia patients. The best strategy to lower one’s risk of dementia, according to Segil, is to alter one’s lifestyle, since middle-aged habits shape one’s later years. He informed us that some tests related to the genetics of dementia do not ensure the onset of dementia and that false-positive test results are common. I would suggest leading a healthy lifestyle to prevent the need for a doctor’s prescription medication. If medication is required, I would suggest consulting a board-certified neurologist for guidance on which medications to take as you age.
Over 55 million people worldwide suffer from dementia, which is estimated to cost more than $1 trillion. Up to 70% of those affected have Alzheimer’s disease, which is typified by the accumulation of two proteins, tau and amyloid. Adults with early symptomatic Alzheimer’s disease, including those with mild cognitive impairment (MCI) and mild dementia with confirmed amyloid plaques, can now receive treatment with the monoclonal antibody donanemab, which was approved by the Food and Drug Administration (FDA) in July 2024. In 2024, the FDA granted accelerated approval to two additional monoclonal antibodies, lecanemab and aducanumab, after encouraging trial outcomes.
Alzheimer’s disease can be managed with the help of current treatments, but the disease’s progression is unaffected. In a global phase 3 clinical study, donanemab reduced cognitive decline in individuals with low/medium tau levels by 35% when compared to a placebo. There is broad agreement that multiple approaches are likely required to provide maximally effective treatment and the authors of the new review point out that these treatments target a single pathway in a complex condition and carry a significant risk of severe side effects. Although they emphasize that repurposing current medications for potential dementia treatment is a global priority, experts argue that, given the complexity of dementia and Alzheimer’s disease, more research is necessary to determine the specific effects of such medications.