Dementia Drugs Seen Lowering Risk for Macular Degeneration

Key Takeaways

• Use of acetylcholinesterase inhibitors (AChEIs) for dementia, such as donepezil (Aricept), may reduce the risk that patients will develop age-related macular degeneration (AMD).
• Randomized clinical trials would be needed to determine if there is a cause-and-effect relationship, and further research is required to validate these findings across diverse populations.

There has been conflicting research into whether Alzheimer’s disease and AMD are connected. Given that the two diseases may have similar causes related to buildup of beta-amyloid proteins, Joseph Magagnoli, MS, of the University of South Carolina in Columbia, and colleagues launched an analysis into whether acetylcholinesterase inhibitors (AChEIs), drugs such as donepezil (Aricept) that are used to slow cognitive loss, could be effective in reducing the incidence of AMD. 

For the new study, the researchers tracked 12,487 VA patients with Alzheimer’s diagnoses who were given AChEIs — donepezil, rivastigmine (Exelon), and galantamine (Razadyne) — and 4,898 receiving a different type of dementia drug, the N-methyl-D-aspartate antagonist memantine (Namenda), either concurrently or separately. These patients were compared with a control group of 8,486 patients who took neither drug but were otherwise similar.

The researchers discovered that each year of AChEI treatment was linked with a 6% lower risk of developing AMD. However, study limitations included its retrospective nature, the possibility of unmeasured confounders (variables that are associated with both factors being measured in an experiment that can falsely demonstrate an apparent association when no real association exists), and its focus on the VA population, which is not representative of the general older public. The study also didn’t account for genetic risk factors, the researchers noted. “Randomized clinical trials would be needed to determine if there is a cause-and-effect relationship, and further research is required to validate these findings across diverse populations,” the researchers said. The results were published in JAMA Ophthalmology.

Edited by Miriam Kaplan, PhD

Source: Randy Dotinga, MedPage Today, January 4, 2024; see source article