Oral anticoagulants: A plausible new treatment for Alzheimer's disease?

Raquel Toribio-Fernandez, Carlos Ceron, Catarina Tristão-Pereira, Irene Fernandez-Nueda, Ana Perez-Castillo, Jose Fernandez-Ferro, Maria Angeles Moro, Borja Ibañez, Valentin Fuster, Marta Cortes-Canteli

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Alzheimer's disease (AD) and cardiovascular disease (CVD) are strongly associated. Both are multifactorial disorders with long asymptomatic phases and similar risk factors. Indeed, CVD signatures such as cerebral microbleeds, micro-infarcts, atherosclerosis, cerebral amyloid angiopathy and a procoagulant state are highly associated with AD. However, AD and CVD co-development and the molecular mechanisms underlying such associations are not understood. Here, we review the evidence regarding the vascular component of AD and clinical studies using anticoagulants that specifically evaluated the development of AD and other dementias. Most studies reported a markedly decreased incidence of composite dementia in anticoagulated patients with atrial fibrillation, with the highest benefit for direct oral anticoagulants. However, sub-analyses by differential dementia diagnosis were scarce and inconclusive. We finally discuss whether anticoagulation could be a plausible preventive/therapeutic approach for AD and, if so, which would be the best drug and strategy to maximize clinical benefit and minimize potential risks. LINKED ARTICLES: This article is part of a themed issue From Alzheimer's Disease to Vascular Dementia: Different Roads Leading to Cognitive Decline. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.6/issuetoc.

Original languageEnglish
Pages (from-to)760-776
Number of pages17
JournalBritish Journal of Pharmacology
Volume181
Issue number6
DOIs
StatePublished - Mar 2024

Keywords

  • cardiovascular risk factors
  • cerebral blood flow
  • cerebrovascular disease
  • dementia
  • intracranial haemorrhages
  • thrombosis

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