Prostate Drugs and Dementia with Lewy Bodies Risk

Prostate Drugs Like Terazosin May Help Lower Dementia with Lewy Bodies Risk

Some commonly prescribed prostate medications are linked to a reduced risk of dementia with Lewy bodies. Dementia with Lewy bodies is the second most prevalent neurodegenerative dementia in older adults, with no current cure. Researchers from the University of Iowa found that men taking three common prostate medications might lower their risk of developing this type of dementia.

The Cause and Current Treatments

Dementia with Lewy bodies is likely caused by deposits of a protein called alpha-synuclein in the brain. While treatments are available to manage symptoms, none can stop disease progression. According to Jacob E. Simmering, PhD, assistant professor at the University of Iowa, there is an urgent need for therapies that can slow or prevent this condition.

The Study's Findings

In their study, Simmering and his team discovered that males taking terazosin, doxazosin, or alfuzosin were less likely to develop dementia with Lewy bodies. These drugs, commonly used to treat urinary issues caused by an enlarged prostate, activate an enzyme called PGK1, which produces ATP, the energy source for cells. This effect was observed to slow or halt neurodegeneration in animal models.

Comparison with Other Prostate Medications

Researchers compared participants taking terazosin, doxazosin, or alfuzosin to those taking tamsulosin or 5ARIs, finding that the former group had a significantly lower risk of developing dementia with Lewy bodies. Over a three-year follow-up, men on terazosin, doxazosin, or alfuzosin were 40% less likely to develop the condition compared to those on tamsulosin, and 37% less likely than those on 5ARIs.

Implications of the Results

The results are promising, suggesting that prostate medications could have neuroprotective effects. However, further research is needed to confirm these findings and understand the mechanisms involved. This potential new avenue for reducing the risk of dementia with Lewy bodies is especially important given the significant impact of this disease on quality of life and the lack of effective preventive treatments.

"I am excited about these results for many reasons," Simmering told us. "[Dementia with Lewy bodies] is a progressive disease in dire need of an effective neuroprotective therapy. We have decades of clinical experience and safety data on these medications, often in elderly patients — the population at the most risk of neurodegenerative diseases."

Expert Opinions

Verna Porter, MD, director of the Dementia, Alzheimer’s Disease, and Neurocognitive Disorders at Pacific Neuroscience Institute, views the findings cautiously but optimistically. She highlights the need for more research to confirm these results and explore new methods to reduce the risk of dementia with Lewy bodies, emphasizing the potential to improve quality of life and reduce healthcare costs.

"The findings are promising, suggesting that certain commonly used prostate drugs could potentially offer a protective effect against [dementia with Lewy bodies]," Porter told us. "Given the significant impact [dementia with Lewy bodies] has on patients’ quality of life and the current lack of effective preventive treatments, this study opens a potential new avenue for reducing the risk of this debilitating disease."

"However," she cautioned, "I am also aware that the study establishes an association rather than causation, so further research is necessary to confirm these findings and understand the underlying mechanisms."