Comparison of drug classes and their association with different diagnostic methods for dementia

A high prevalence of comorbid conditions is observed in individuals with mild cognitive impairment (MCI) and dementia. Evidently, this is accompanied by polypharmacy which complicates disease progression, and our understanding of the same. In the present study, we aim to identify which drug classes are significantly associated with disease progression, and how this association differs depending on different diagnostic variables. The NACC database, one of the most comprehensive longitudinal databases for dementia research, was used in this study. Drug classes analysed using multivariate logistic regression were antihypertensives, anticoagulants, antidepressants, antipsychotics, anxiolytics, lipid-lowering, nonsteroidal anti-inflammatory (NSAIDs), diabetes, Alzheimer’s, and Parkinson’s medication. Analysis was conducted at baseline, and in terms of progression to MCI/dementia using clinician diagnosis and CDRSOB scores as the diagnostic outcome. With CDRSB as the outcome, antiadrenergics were significantly associated with reduced MCI-to-Dementia risk for men (odds ratio, OR: 0.68, p<0.001), diuretics on the other hand increased Healthy-to-MCI risk in women (OR: 1.48, p: 0.002). NSAIDs reduced Healthy-to-MCI risk (OR: 0.64, p<0.001) with clinician diagnosis as the outcome. Anxiolytics, specifically benzodiazepines reduced MCI-to-Dementia risk (OR: 0.71, p:0.006) with CDRSB as the outcome. Various drug classes are significantly associated with progression to MCI/dementia. However, discrepancies are observed between analyses employing clinician diagnosis and CDRSOB scores as the outcome. Additionally, the associations appear to be gender-specific. Further analysis may aid our understanding of the relationship between different drug classes and cognition and enhance prescribing practices across clinics.