患有痴呆症的风险与过活性膀的抗胆固醇药物相关的风险在55岁以上的成年人中:嵌套病例控制研究研究
Barbara Iyen1, Carol Coupland1, Brian Gregory Bell1
1Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
BMJ medicine
|November 22, 2024
概括
某些抗胆固醇药物用于过度活动的膀,包括oxybutynin,solifenacin和tolterodine,与老年人痴呆风险增加有关. 临床医生在开处方时应考虑这些长期风险.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
背景情况:
- 过度活跃的膀 (OAB) 影响了老年成人人口的很大一部分.
- 抗胆固醇药物通常用于OAB,但具有潜在的副作用.
- 特定抗胆固醇药物与痴呆风险之间的关联需要进一步调查.
研究的目的:
- 调查与各种抗胆固醇药物治疗过活性膀相关的发生性痴呆的差异性风险.
- 分析这些风险在英国的老年人中大量的代表性人口中.
主要方法:
- 采用了一个嵌套的病例控制研究设计.
- 使用了来自英国全科医院 (CPRD GOLD) 和医院情节统计数据的数据.
- 分析了170,742名年龄≥55岁的患者,痴呆病例与对照病例相匹配.
主要成果:
- 任何抗胆固醇OAB药物的使用都与痴呆症风险增加有关 (aOR 1.18).
- 氧化丁氨酸化物,索利芬酸盐和托尔特罗丁酸盐显示,与痴呆风险的关联最强.
- 对于达里芬素,费索特罗丁烟酸盐,弗拉沃沙特化物,普罗比维林化物和特罗斯皮化物,没有观察到显著的痴呆风险增加.
结论:
- 氧化丁氨酸,索利芬氨酸和托尔特罗丁与老年人痴呆风险最为密切相关.
- 临床医生应权衡抗胆固醇OAB治疗的长期风险.
- 建议考虑具有潜在较低痴呆风险的替代OAB治疗方法.
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