Can anticoagulants prevent Alzheimer’s disease?
Several experiments conducted in mice models have revealed that anticoagulation delays the decline in memory loss and conversion to Alzheimer’s disease (AD). Moreover, in humans, there has been increasing evidence AD is associated with a chronic procoagulant state.
Data from a 1-year long-term study involving chronic dabigatrin administration in a mice AD-model seem to confirm these findings. A study, published on October 7, 2019 in the Journal of the American College of Cardiology (JACC), has demonstrated that following 1-year dabigatrin the mice had neither memory loss nor any reduction in cerebral circulation. In addition, dabigatrin administration was shown associated with a decrease in typical AD signs, such as cerebral inflammation, blood vessel injury, and amyloid protein plaques.
The study authors concluded that dabigatrin treatment over 12 months prevented memory decline, cerebral hypoperfusion, and toxic fibrin deposition in the mice. Of note is that Dr. Alois Alzheimer, more than a century ago, already stated that this condition was likely to be a disease of the blood vessels, which had been forgotten overall many years.
Nevertheless, numerous unanswered questions remain. One of the drawbacks of using anticoagulation for AD management is the increased risk of intracranial bleeding. In addition, it must be acknowledged that we know very little regarding the impact of long-term anticoagulation in the frail, elderly AD population.
http://www.onlinejacc.org/content/74/15/1910
Reference: Cortes-Canteli M, Kruyer A, Fernandez-Nueda I, et al. Long-Term Dabigatran Treatment Delays Alzheimer’s Disease Pathogenesis in the TgCRND8 Mouse Model. J Am Coll Cardiol 2019;74:1910-1923.