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Title: Diuretic medication use reduces incident dementia risk: A meta-analysis of prospective studies
Contributor(s): Tully, P  (author)orcid ; Hanon, O (author); Cosh, S  (author)orcid ; Tzourio, C (author)
Publication Date: 2016-03
DOI: 10.1016/j.eurpsy.2016.01.044
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Abstract: Introduction: Numerous observational studies suggest that blood pressure management with antihypertensive drugs may be effective in reducing dementia risk. Objective: To quantify dementia risk in relation to diuretic medication use. Methods: Electronic databases were searched until June 2015. Eligibility criteria: population, adults without dementia at baseline from primary care, community cohort, residential/institutionalized or randomized controlled trial (RCT); exposure, diuretic medication; comparison, no diuretic medication, other or no antihypertensive medication, placebo-control; outcome, incident dementia in accordance with standardized criteria. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) were pooled in fixed-effects models with RevMan 5.3. The overall quality and strength of evidence was rated with GRADE criteria. Results: Fifteen articles were eligible comprising a pooled sample of 52,599 persons and 3444 incident dementia cases (median age 76.1 years, 40% male) with a median follow-up of 6.1 years. Diuretic use was associated with 17% reduction in dementia risk (HR 0.83; 95% CI 0.75 to 0.90) and a 21% reduction in Alzheimer's disease risk (HR 0.79; 95% CI 0.68 to 0.93). GRADE was rated as moderate. Risk estimates were consistent comparing monotherapy versus combination therapy, study design and follow-up. Meta-regression did not suggest that age, gender, systolic blood pressure, attrition, mortality rate, education, cognitive function, stroke, Apolipoprotein E allele, heart failure or diabetes altered the primary results. Conclusions: Diuretic medication was associated with a consistent reduction in dementia and Alzheimer's disease risk and the absence of heterogeneity points to the generalizability of these findings.
Publication Type: Conference Publication
Conference Details: EPA 2016: 24th European Congress of Psychiatry, Madrid, Spain, 12th - 15th March, 2016
Source of Publication: v.33, p. S87
Publisher: Elsevier Masson
Place of Publication: France
ISSN: 1778-3585
Fields of Research (FoR) 2008: 110319 Psychiatry (incl. Psychotherapy)
170102 Developmental Psychology and Ageing
Fields of Research (FoR) 2020: 320221 Psychiatry (incl. psychotherapy)
520101 Child and adolescent development
520106 Psychology of ageing
Socio-Economic Objective (SEO) 2008: 920410 Mental Health
920502 Health Related to Ageing
Socio-Economic Objective (SEO) 2020: 200409 Mental health
200502 Health related to ageing
Peer Reviewed: Yes
HERDC Category Description: E3 Extract of Scholarly Conference Publication
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Appears in Collections:Conference Publication
School of Psychology

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