Prostate Drugs May Reduce Dementia Risk: Study

A recent observational study from the University of Iowa Health Care suggests that drugs commonly used to treat enlarged prostate may also reduce the risk of dementia with Lewy bodies (DLB). The research, leveraging data from the Merative MarketScan database, examined over 643,000 men who began treatment for benign prostatic hyperplasia using one of six standard therapies.

The study focused on three α-1 adrenergic receptor antagonists, often called α-blockers. These include terazosin (Hytrin by Abbott), doxazosin (Cardura by Pfizer), and alfuzosin (Uroxatral by Sanofi). α-blockers function by relaxing smooth muscles, but they also activate an enzyme crucial for ATP production, the molecule responsible for cellular energy. The researchers hypothesized that this secondary effect might help mitigate neurodegenerative processes in the brain.

For comparison, the study also tracked men treated with tamsulosin and the 5α-reductase inhibitors (5ARIs) finasteride and dutasteride, which do not influence brain energy production.

None of the study participants had a history of DLB at the start. They were monitored until they either left the database or developed DLB. After around three years on average, results indicated that men on the three α-blockers had a 40% lower risk of developing DLB compared to those on tamsulosin. When compared to men using 5ARIs, the risk was 27% lower for those on α-blockers. These findings were statistically significant.

Conversely, the likelihood of developing DLB was similar for men treated with tamsulosin and those on 5ARIs. The results were confirmed through various sensitivity analyses, reinforcing their robustness.

The findings were published in the journal Neurology, the official publication of the American Academy of Neurology. Jacob Simmering, an assistant professor of internal medicine at the University of Iowa and the study's lead author, emphasized the potential impact of these drugs: "If terazosin and similar medications can help slow this progression—if not outright preventing the disease—it would be crucial for preserving cognitive function and quality of life in people with DLB."

However, the researchers cautioned that the study's observational nature means it only shows a statistical correlation, not causation. The directionality of the association remains unclear.

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