A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline

Penny A. Dacks; Joshua J. Armstrong; Stephen K. Brannan; Aaron J. Carman; Allan M. Green; M. Sue Kirkman; Lawrence R. Krakoff; Lewis H. Kuller; Lenore J. Launer; Simon Lovestone; Elizabeth Merikle; Peter J. Neumann; Kenneth Rockwood; Diana W. Shineman; Richard G. Stefanacci; Priscilla Velentgas; Anand Viswanathan; Rachel A. Whitmer; Jeff D. Williamson; Howard M. Fillit

doi:10.1186/s13195-016-0200-3

A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline

Penny A. Dacks, Joshua J. Armstrong, Stephen K. Brannan, Aaron J. Carman, Allan M. Green, M. Sue Kirkman, Lawrence R. Krakoff, Lewis H. Kuller, Lenore J. Launer, Simon Lovestone, Elizabeth Merikle, Peter J. Neumann, Kenneth Rockwood, Diana W. Shineman, Richard G. Stefanacci, Priscilla Velentgas, Anand Viswanathan, Rachel A. Whitmer, Jeff D. Williamson, Howard M. Fillit

Research output: Contribution to journal › Review article › peer-review

11 Citations (Scopus)

Abstract

Common diseases like diabetes, hypertension, and atrial fibrillation are probable risk factors for dementia, suggesting that their treatments may influence the risk and rate of cognitive and functional decline. Moreover, specific therapies and medications may affect long-term brain health through mechanisms that are independent of their primary indication. While surgery, benzodiazepines, and anti-cholinergic drugs may accelerate decline or even raise the risk of dementia, other medications act directly on the brain to potentially slow the pathology that underlies Alzheimer's and other dementia. In other words, the functional and cognitive decline in vulnerable patients may be influenced by the choice of treatments for other medical conditions. Despite the importance of these questions, very little research is available. The Alzheimer's Drug Discovery Foundation convened an advisory panel to discuss the existing evidence and to recommend strategies to accelerate the development of comparative effectiveness research on how choices in the clinical care of common chronic diseases may protect from cognitive decline and dementia.

Original language	English
Article number	200
Journal	Alzheimer's Research and Therapy
Volume	8
Issue number	1
DOIs	https://doi.org/10.1186/s13195-016-0200-3
Publication status	Published - Aug 20 2016

Bibliographical note

Funding Information:
This position paper and the corresponding advisory panel were funded by the Alzheimer’s Drug Discovery Foundation. Support for authors’ time was provided by the Canadian Consortium on Neurodegeneration in Aging (JJA); the Intramural Research Program, National Institute on Aging, NIH (LJL); NIH-NIA grants K23 AG028726 and R01AG047975 (AV). Takeda Pharmaceuticals provided some support for the advisory panel; the American Heart Association supported the cost of travel for their representative (AV).

Publisher Copyright:
© 2016 The Author(s).

ASJC Scopus Subject Areas

Neurology
Clinical Neurology
Cognitive Neuroscience

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s13195-016-0200-3

Cite this

Dacks, P. A., Armstrong, J. J., Brannan, S. K., Carman, A. J., Green, A. M., Kirkman, M. S., Krakoff, L. R., Kuller, L. H., Launer, L. J., Lovestone, S., Merikle, E., Neumann, P. J., Rockwood, K., Shineman, D. W., Stefanacci, R. G., Velentgas, P., Viswanathan, A., Whitmer, R. A., Williamson, J. D., & Fillit, H. M. (2016). A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline. Alzheimer's Research and Therapy, 8(1), Article 200. https://doi.org/10.1186/s13195-016-0200-3

Dacks, PA, Armstrong, JJ, Brannan, SK, Carman, AJ, Green, AM, Kirkman, MS, Krakoff, LR, Kuller, LH, Launer, LJ, Lovestone, S, Merikle, E, Neumann, PJ, Rockwood, K, Shineman, DW, Stefanacci, RG, Velentgas, P, Viswanathan, A, Whitmer, RA, Williamson, JD & Fillit, HM 2016, 'A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline', Alzheimer's Research and Therapy, vol. 8, no. 1, 200. https://doi.org/10.1186/s13195-016-0200-3

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abstract = "Common diseases like diabetes, hypertension, and atrial fibrillation are probable risk factors for dementia, suggesting that their treatments may influence the risk and rate of cognitive and functional decline. Moreover, specific therapies and medications may affect long-term brain health through mechanisms that are independent of their primary indication. While surgery, benzodiazepines, and anti-cholinergic drugs may accelerate decline or even raise the risk of dementia, other medications act directly on the brain to potentially slow the pathology that underlies Alzheimer's and other dementia. In other words, the functional and cognitive decline in vulnerable patients may be influenced by the choice of treatments for other medical conditions. Despite the importance of these questions, very little research is available. The Alzheimer's Drug Discovery Foundation convened an advisory panel to discuss the existing evidence and to recommend strategies to accelerate the development of comparative effectiveness research on how choices in the clinical care of common chronic diseases may protect from cognitive decline and dementia.",

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AU - Launer, Lenore J.

AU - Lovestone, Simon

AU - Merikle, Elizabeth

AU - Neumann, Peter J.

AU - Rockwood, Kenneth

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AU - Williamson, Jeff D.

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N2 - Common diseases like diabetes, hypertension, and atrial fibrillation are probable risk factors for dementia, suggesting that their treatments may influence the risk and rate of cognitive and functional decline. Moreover, specific therapies and medications may affect long-term brain health through mechanisms that are independent of their primary indication. While surgery, benzodiazepines, and anti-cholinergic drugs may accelerate decline or even raise the risk of dementia, other medications act directly on the brain to potentially slow the pathology that underlies Alzheimer's and other dementia. In other words, the functional and cognitive decline in vulnerable patients may be influenced by the choice of treatments for other medical conditions. Despite the importance of these questions, very little research is available. The Alzheimer's Drug Discovery Foundation convened an advisory panel to discuss the existing evidence and to recommend strategies to accelerate the development of comparative effectiveness research on how choices in the clinical care of common chronic diseases may protect from cognitive decline and dementia.

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A call for comparative effectiveness research to learn whether routine clinical care decisions can protect from dementia and cognitive decline

Abstract

Bibliographical note

ASJC Scopus Subject Areas

UN SDGs

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