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

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 pr...

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Published in:British journal of pharmacology 2024-03, Vol.181 (6), p.760-776
Main Authors: Toribio‐Fernandez, Raquel, Ceron, Carlos, Tristão‐Pereira, Catarina, Fernandez‐Nueda, Irene, Perez‐Castillo, Ana, Fernandez‐Ferro, Jose, Moro, Maria Angeles, Ibañez, Borja, Fuster, Valentin, Cortes‐Canteli, Marta
Format: Article
Language:English
Subjects:
Alzheimer's disease
Amyloid
Anticoagulants
Arteriosclerosis
Cardiovascular diseases
cardiovascular risk factors
Cerebral amyloid angiopathy
cerebral blood flow
cerebrovascular disease
Cognitive ability
Dementia
Dementia disorders
intracranial haemorrhages
Molecular modelling
Neurodegenerative diseases
Risk factors
thrombosis
Vascular dementia
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Summary: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
ISSN:0007-1188
1476-5381
DOI:10.1111/bph.16032