Alzheimer's & dementia (Amsterdam, Netherlands) · 2026
Polypharmacy is associated with lower progression from MCI to Alzheimer's disease, with sex-specific patterns across drug classes.
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García-Zamora Mar, Pardo Juan, Esteve Miriam, Martinez-Gracia Alejandro, Cháfer-Pericás Consuelo, Falcó Antonio
Аннотация
INTRODUCTION: Polypharmacy is often considered harmful in older adults, yet several cardiovascular and psychiatric drugs target modifiable dementia risk factors. We examined the association between polypharmacy and progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD), overall and by sex.
METHODS: In a retrospective cohort of 4557 adults ≥ 50 years with MCI, followed for a mean of 68.7 months, polypharmacy was defined as ≥ 5 medications. Cox models adjusted for age and sex estimated hazard ratios (HRs), including sex-stratified analyses.
RESULTS: Polypharmacy may be associated with lower likelihood of progression to AD. Sex-stratified analyses suggested differences: antidiabetics, antithrombotics, sedatives, and antidepressants were mainly associated with lower progression in women; antihypertensives in men; anxiolytics, antipsychotics, and antidementia drugs in both sexes.
DISCUSSION: These observational findings indicate possible associations between medication use and MCI to AD progression, with potential sex-specific patterns, but causality cannot be inferred. Unmeasured factors and limited covariate adjustment may contribute.
METHODS: In a retrospective cohort of 4557 adults ≥ 50 years with MCI, followed for a mean of 68.7 months, polypharmacy was defined as ≥ 5 medications. Cox models adjusted for age and sex estimated hazard ratios (HRs), including sex-stratified analyses.
RESULTS: Polypharmacy may be associated with lower likelihood of progression to AD. Sex-stratified analyses suggested differences: antidiabetics, antithrombotics, sedatives, and antidepressants were mainly associated with lower progression in women; antihypertensives in men; anxiolytics, antipsychotics, and antidementia drugs in both sexes.
DISCUSSION: These observational findings indicate possible associations between medication use and MCI to AD progression, with potential sex-specific patterns, but causality cannot be inferred. Unmeasured factors and limited covariate adjustment may contribute.