Medication used to reduce patients’ risk of developing blood clots may also reduce the rate of cognitive decline related to Alzheimer’s. Patients with atrial fibrillation and Alzheimer’s disease appeared to see slower decline when taking certain blood-thinning medications than others, according to recently published peer-reviewed research. The study involved data from the Swedish Register for Cognitive Disorders/Dementia and was published in the European Heart Journal Wednesday. Led by Maria Erisdotter, a professor at the prestigious medical school Karolinska Institutet in Stockholm and geriatric-care consultant at the Karolinska University Hospital, a research team analyzed information from 7,308 patients. They found that those whose heart rhythm disorders were being treated with newer anticoagulants saw “significantly slower” declines to their cognitive functioning, as measured by a standardized examination. That’s when compared to two other groups – patients on an older anticoagulant drug known as warfarin, and those who were not taking any anticoagulants. Some limitations The research was observational, meaning that scientists cannot be certain that slower cognitive decline was definitively attributable to the drug. There may have been other lifestyle and treatment factors at play that could explain some of the differences. Additionally, researchers noted, it was not known whether some patients switched medications during the course of the study. Still, Eriksdotter said in a news release about the work Wednesday that “there are reasons to believe the treatment could have a positive effect on cognition, for example by improving blood flow and reducing small-scale damage to the brain.” The research focused on patients with Alzheimer’s disease and mixed dementia cases with Alzheimer’s. They recommend further research into other subtypes of dementia. How significant are the findings? As for how much the decline slowed, the difference in examination scores of those on the newer anticoagulants was 0.2 points per year. Scores on the Mini-Mental Status Examination (MMSE) range from 0 to 30, where 30 is normal cognitive function and scores in the zero-to-nine range represent severe impairment. The MMSE is commonly used to evaluate cognitive impairment and dementia, with questions designed to test the patient’s attention, orientation and memory. It can be readministered to track progress. To put the differences in perspective, a researcher on the team described the delays to cognitive decline in a news release as “modest” looking year-over-year. “But over a longer period even such an effect could influence how cognitive function develops,” said Nanbo Zhu, a researcher with Karolinska Institutet’s Department of Neurobiology, Care Sciences and Society. “Our findings suggest that (newer anticoagulant) treatment may also be significant for cognition in this patient group.” The research team noted both newer and older anticoagulants were also tied to lower risk of death, stroke, and blood clots when compared to the outcomes of patients not on these drugs. Patients on the newer medications also had a lower risk of fractures, while those on the older iterations had a higher risk of major bleeding, the study said. Their “take home message” is that, for patients with both conditions, newer anticoagulants seem to be the best treatment option when it comes to slowing decline. The research notes as a conflict of interest that Eriksdotter has worked as a consultant in one-off meetings with, or has given lectures at events sponsored by, several drug companies.
