- Anti-inflammatory drugs like ibuprofen, along with antibiotics, antiviral medications, and vaccines, were associated with a reduced risk of dementia, according to a new systematic review.
- Dementia affects more than 55 million people worldwide at an estimated global cost of more than $1 trillion, and up to 70% of those people have Alzheimer’s disease.
- Experts note that the complexity of dementia in different individuals warrants further study before jumping to any conclusions about repurposing existing drugs for dementia treatment.
Anti-inflammatory drugs like ibuprofen, along with antibiotics, antiviral medications, and vaccines, were seen to be associated with a reduced risk of dementia, according to a new systematic review led by scientists from the University of Cambridge and the University of Exeter, both in the United Kingdom.
The review, published in
By analyzing medical and administrative records and big clinical datasets, the researchers found that antimicrobials, vaccinations, and anti-inflammatory drugs (NSAIDs) were associated with reduced risk of dementia, while vitamins, supplements, antipsychotics, and diabetes medications had some association with an increased risk.
There was conflicting evidence about antidepressants and some blood pressure medications.
The authors noted that some limitations and false positives may have affected findings, and that overall they found “a lack of consistency between studies in identifying individual drugs which modify risk of all-cause dementia or Alzheimer’s disease.”
Emer MacSweeney, MD, CEO and consultant neuroradiologist at Re:Cognition Health, who was not involved in the review, told Medical News Today that people with genetic predispositions to dementia, and those with lifestyle factors that could lead to it may benefit from drugs that target inflammation or infection.
However, she added that this new review did not explain which cohort might respond better to specific drugs.
“It is important to remember that dementia, which just describes a constellation of progressive symptoms, can be due to a number of different pathological conditions. And even Alzheimer’s disease, the most common cause of dementia, by far, as we grow older, is not one disease,” Dr. MacSweeney said. “It is complex and is characterized by many abnormal biomarkers. However, it is well recognized that, like many diseases, most conditions which progress eventually to dementia do largely have a neuroinflammatory origin.”
“To establish a causal link between dementia risk and specific drugs, large-scale, longitudinal, randomized controlled trials (RCTs) are needed,” MacSweeney explained.
“These should control for confounding variables like age, gender, and comorbidities, include genetic and lifestyle data to identify subgroup-specific effects and use biomarkers (e.g., amyloid or tau levels) to measure the biological impact of medications. They should focus on long-term outcomes to confirm reduced dementia incidence,” she further advised.
Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, who was also not involved in the review, expressed some skepticism to MNT about its findings, given how prevalent these medications are already throughout the world:
“Studies often come out showing concern for prescription and over-the-counter medications causing dementia that are not clinically observed. For example, using allergy medications like Benadryl/diphenhydramine has been noted to cause
an increased risk for dementia in studies, which I have never seen to be true in my clinical neurology practice. Medications to help people sleep are often implicated in causing worsening memory loss in the elderly though I believe the benefits of a good night’s sleep outweighs any potential risks.”
In his opinion, “there are too many cooks in the kitchen today and if you are concerned with dementia, you should ask a specialist like myself who diagnoses and treats patients with dementia as their job.”
Ultimately, Segil said, lifestyle changes are the strongest way to reduce one’s risk of dementia, with the behaviors followed in middle age determining what happens later in life.
“The genetics of dementia include some tests which do not guarantee the onset of dementia and there are often false positive tests,” he told us. “I would advise living healthy to avoid the need for a prescription medication from a physician, and if medications are needed, seeing a board-certified neurologist for help navigating which medications you should take as you age.”
Dementia affects more than
In July 2024, the monoclonal antibody donanemab received Food and Drug Administration (FDA) approval as a treatment option for adults with early symptomatic Alzheimer’s disease, including people with mild cognitive impairment (MCI) and mild dementia with confirmed amyloid plaques.
Currently available treatments for Alzheimer’s can help manage symptoms but do not change the course of the disease. In an international phase 3 clinical trial, compared to placebo,
The authors of the new review point out that these treatments “target a single pathway in a complex condition, carry a significant risk of severe side effects, and there is wide consensus that multiple approaches are likely to be needed to provide maximally effective treatment.”
They stress that the repurposing of existing drugs for possible dementia treatment is a global priority, but experts say that more studies need to be conducted to establish concrete effects of such drugs, given the complex nature of dementia and Alzheimer’s.
