Effects of centrally acting ACE inhibitors on the rate of cognitive decline in dementia

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dc.contributor.author Gao, Yang
dc.contributor.author O'Caoimh, Rónán
dc.contributor.author Healy, Liam
dc.contributor.author Kerins, David M.
dc.contributor.author Eustace, Joseph A.
dc.contributor.author Guyatt, Gordon
dc.contributor.author Sammon, David
dc.contributor.author Molloy, D. William
dc.date.accessioned 2019-02-27T16:03:49Z
dc.date.available 2019-02-27T16:03:49Z
dc.date.issued 2013-07-22
dc.identifier.citation Gao, Y., O'Caoimh, R., Healy, L., Kerins, D. M., Eustace, J., Guyatt, G., Sammon, D. and Molloy, D. W. (2013) 'Effects of centrally acting ACE inhibitors on the rate of cognitive decline in dementia', BMJ Open, 3(7), e002881 (8 pp). doi: 10.1136/bmjopen-2013-002881 en
dc.identifier.volume 3 en
dc.identifier.issued 7 en
dc.identifier.startpage e002881-1 en
dc.identifier.endpage e002881-8 en
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10468/7552
dc.identifier.doi 10.1136/bmjopen-2013-002881
dc.description.abstract Objectives: There is growing evidence that antihypertensive agents, particularly centrally acting ACE inhibitors (CACE-Is), which cross the blood–brain barrier, are associated with a reduced rate of cognitive decline. Given this, we compared the rates of cognitive decline in clinic patients with dementia receiving CACE-Is (CACE-I) with those not currently treated with CACE-Is (NoCACE-I), and with those who started CACE-Is, during their first 6 months of treatment (NewCACE-I). Design: Observational case–control study. Setting: 2 university hospital memory clinics. Participants: 817 patients diagnosed with Alzheimer's disease, vascular or mixed dementia. Of these, 361 with valid cognitive scores were included for analysis, 85 CACE-I and 276 NoCACE-I. Measurements: Patients were included if the baseline and end-point (standardised at 6 months apart) Standardised Mini-Mental State Examination (SMMSE) or Quick Mild Cognitive Impairment (Qmci) scores were available. Patients with comorbid depression or other dementia subtypes were excluded. The average 6-month rates of change in scores were compared between CACE-I, NoCACE-I and NewCACE-I patients. Results: When the rate of decline was compared between groups, there was a significant difference in the median, 6-month rate of decline in Qmci scores between CACE-I (1.8 points) and NoCACE-I (2.1 points) patients (p=0.049), with similar, non-significant changes in SMMSE. Median SMMSE scores improved by 1.2 points in the first 6 months of CACE treatment (NewCACE-I), compared to a 0.8 point decline for the CACE-I (p=0.003) group and a 1 point decline for the NoCACE-I (p=0.001) group over the same period. Multivariate analysis, controlling for baseline characteristics, showed significant differences in the rates of decline, in SMMSE, between the three groups, p=0.002. Conclusions: Cognitive scores may improve in the first 6 months after CACE-I treatment and use of CACE-Is is associated with a reduced rate of cognitive decline in patients with dementia. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group en
dc.relation.uri https://bmjopen.bmj.com/content/bmjopen/3/7/e002881.full.pdf
dc.rights © 2013 The Authors. Published by the BMJ Publishing Group Limited. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode en
dc.rights.uri http://creativecommons.org/licenses/by-nc/3.0/ en
dc.subject Dipeptidyl carboxypeptidase inhibitor en
dc.subject Aged en
dc.subject Cognitive defect en
dc.subject Controlled study en
dc.subject Dementia en
dc.subject Hospital based case control study en
dc.subject Mini Mental State Examination en
dc.subject Observational study en
dc.subject Outcome assessment en
dc.subject Quick Mild Cognitive Impairment score en
dc.subject Scoring system en
dc.subject University hospital en
dc.title Effects of centrally acting ACE inhibitors on the rate of cognitive decline in dementia en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother David Sammon, Business Information Systems, University College Cork, Cork, Ireland. +353-21-490-3000 Email: dsammon@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2019-02-27T15:54:09Z
dc.description.version Published Version en
dc.internal.rssid 475272572
dc.contributor.funder Atlantic Philanthropies en
dc.contributor.funder Health Service Executive, Ireland en
dc.contributor.funder Irish Hospice Foundation en
dc.contributor.funder Canadian Institutes of Health Research en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Bmj Open en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress dsammon@ucc.ie en


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© 2013 The Authors. Published by the BMJ Publishing Group Limited. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode Except where otherwise noted, this item's license is described as © 2013 The Authors. Published by the BMJ Publishing Group Limited. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode
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