August 05, 2024
According to new research from the University of Iowa, medications used for prostate enlargement may provide clues to future strategies to prevent dementia with Lewy bodies (DLB).
While the causes of LBD are not entirely clear, researchers are exploring numerous ways in which it might be possible to prevent the disease or reduce risk. One route that scientists are currently examining is the role of how the body uses energy as we age. It is possible that changes in how we utilize energy as we age may predispose us to certain brain diseases, including LBD and Parkinson’s disease. Because some medications are already known to change the way the body uses energy, doctors are examining whether people who take such medications may have higher or lower risk of developing LBD. This summer, writing in the medical journal Neurology, a group of researchers reported the results of one such study.
What was the study about?
Prior research studies in animal models suggests that certain medications for prostate enlargement—namely terazosin, doxazosin, and alfuzosin—may decrease the risk of diseases such as Parkinson’s disease, Alzheimer’s disease, and amyotrophic lateral sclerosis (ALS; also known as Lou Gehrig’s disease). All of these medications are known to impact the body’s energy usage, as well. However, it is not yet known whether these medications change risk for DLB in people.
To begin to grapple with this question, the researchers reviewed health insurance claims data for more than 200 million people with private insurance or Medicare supplemental insurance in the US between the years of 2001 and 2017. The idea was to see whether people who took these medications were less likely to develop DLB. However, people who take these medications differ in two important ways from the general population. First, because these medications are generally taken for prostate enlargement, the researchers also examined other medications for prostate enlargement that do not affect the way the body uses energy. This allows the researchers to be more confident that any change in DLB risk is associated with the medications that affect energy usage, rather than associated with needing treatment for an enlarged prostate (researchers refer to the latter as indication bias). Second, the research utilized only men, an important limitation of the study.
What were the findings?
Of the men included in this study, it was found that prior use of one of the medications that changes energy usage in the body was associated with a substantial reduction in the likelihood that they would later develop DLB. The reduction in risk was in the range of 27% to 40% when compared to the medications for enlarged prostate that do not change the way the body uses energy.
What does this mean for me?
While these results are exciting, they are not expected to change prevention or treatment strategies in the near term. Rather, this kind of study provides evidence that increases confidence among scientists that changing energy usage in the body may be a realistic path to pursue in risk reduction research. No one should change the medications they are currently taking—far more research is needed before we will understand whether that would be harmful or helpful. The next steps for this line of research may involve clinical trials with one or more of these medications, or it may involve searching for other new or existing medications that work similarly but carry fewer side effects. A key next step will be understanding whether these medications might carry similar expected benefit in women, a question that the study described here is unable to answer.
If you are currently experiencing DLB or Parkinson’s disease dementia (PDD, the other major form of Lewy body dementia), we encourage you to view our resources for people living with LBD and for their care partners.
Reference:
Hart A, Aldridge G, Zhang Q, Narayanan NS, and Simmering JE. 2024. Association of terazosin, doxazosin, and alfuzosin use and risk of dementia with Lewy bodies in men. Neurology, 103. doi: 10.1212/WNL.0000000000209570