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Fagan and colleagues1 reported on the use of the CSF tau/Aβ42 ratio in predicting cognitive decline in nondemented older adults. Although they stated that participants in the study had no systemic medical illness that could contribute importantly to dementia, they made no mention of the participants' medication profiles.
Statins have been thought to play a role in preventing cognitive decline2 and possibly in altering CSF biomarkers3 among patients with Alzheimer disease (AD). In the preliminary results of a randomized controlled trial, the use of atorvastatin in patients with mild to moderate AD was shown to be beneficial in improving their cognitive scores on the Alzheimer's Disease Assessment Scale at 6 and 12 months.2 In addition, CSF levels of ptau were reduced among patients treated with simvastatin.3 These effects of statins could have been confounding factors in the results of the study by Fagan and colleagues.
Other common medications have also been suggested as possible treatments to slow the progression of AD. Medications that inhibit cyclooxygenase-1 such as indomethacin and diclofenac/misoprostol continue to be studied due to their anti-inflammatory effects.4 Patients with mild AD or MCI who received rosiglitazone were shown to exhibit better delayed recall and selective attention at 6 months.5 Administration of high-dose estradiol also significantly improved attention, verbal memory, and visual memory compared with placebo among postmenopausal women with AD.6
Because the use of statins, nonsteroidal anti-inflammatory drugs, thiazolidinediones, and estrogen is so ubiquitous among patients in the 60- to 91-year-old demographic that Fagan and colleagues studied, the profile of medication use among the study participants would be quite relevant in determining the validity of the study results.
Correspondence: Dr Wong, John A. Burns School of Medicine, University of Hawaii, PO Box 23377, Honolulu, HI 96823 (wongvict@hawaii.edu).
Financial Disclosure: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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