系统性药物和痴呆风险:一个系统的总体审查
Clara Belessiotis-Richards1,2, Joseph Hayes3,4, Ying Feng Yap5,6
1Division of Psychiatry, University College London, London, United Kingdom. c.belessiotis@ucl.ac.uk.
Molecular psychiatry
|July 24, 2025
概括
系统性药物,如抗高血压药和他类药物,可能会降低痴呆风险,而抗胆固醇药可能会增加它. 建议主动治疗高血压,但药物重新用于预防痴呆症需要更多的证据.
科学领域:
- 神经学 神经学
- 药理学 药理学 是一个学科.
- 流行病学 流行病学
背景情况:
- 以前的元分析表明,全身药物可以影响痴呆风险.
- 对于临床指导和研究方向,需要对现有证据进行概述.
研究的目的:
- 对系统性药物和痴呆风险的元分析进行总体审查.
- 综合证据,以告知临床实践和未来的研究重点.
主要方法:
- 68项元分析 (PROSPERO CRD42021226307) 的总体综述,从开始到2024年4月.
- 包括对人类痴呆风险和全身药物进行同行评审的元分析.
- 使用AMSTAR-2进行质量评估,使用GRADE对证据的确定性进行评分.
主要成果:
- 中等确定性证据表明,使用抗高血压药物,他类药物,SGLT2抑制剂和GLP-1RA降低了痴呆风险.
- 中等确定性证据表明,抗胆固醇药物增加了痴呆风险.
- 观测数据占主导地位,包括混和逆因果关系在内的局限性;RCT数据支持高血压治疗的好处.
结论:
- 目前没有足够的证据支持仅仅为了降低痴呆风险而重新使用全身药物.
- 建议主动管理高血压,以降低所有原因的痴呆风险.
- 建议在认知障碍中避免使用抗胆类药物,并评估负担并考虑替代品.
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