Amlodipine use in Mild Cognitive Impairment reduces the risk of incident dementia in National Alzheimer’s Coordinating Center participants aged ≥55 years from 2014-2019

Abstract

<b>Abstract ID 55217</b> <b>Poster Board 428</b> There is increasing evidence that amlodipine may be useful in preventing dementia. Whether amlodipine use in mild cognitive impairment (MCI) protects against dementia remains unclear. This study evaluated the hypothesis that reported use of amlodipine in MCI would reduce the risk of incident dementia using National Alzheimer’s Coordinating Center (NACC) participants aged ≥55 years from 2014-2019. Inclusion criteria included NACC participants aged ≥55 years visiting an Alzheimer’s Disease Center from 1/1/2014-12/31/2019 with a diagnosis of MCI and ≥ 2 visits with complete medications forms. Amlodipine use was defined as any reported use of amlodipine prior to being censored or diagnosed with dementia by a clinician. Reported medication use was based on co-participant report of participant medication use within the past 14 days. There were 3,527 participants with MCI that met inclusion criteria, with 589 (16.7 %) amlodipine users. At the initial MCI visit, significant systematic differences were found between amlodipine users and nonusers. To control for this, participants were matched at the initial MCI visit. All amlodipine users were matched resulting in a total sample size of 1178. Following matching, amlodipine users were similar to nonusers for all variables with exception of hypercholesterolemia (amlodipine user: 463/589, 78.6%; nonuser: 430/589, 73.0%, p=0.0248, chi-square). An extended Cox proportional hazards survival model was used to model the risk of incident dementia with amlodipine use with time following MCI diagnosis. The adjusted risk of incident dementia for amlodipine users was 32% lower (adjusted hazard ratio, HR=0.68, 95% CI: 0.53, 0.86) compared to non-users when adjusting for age category, APOE4, race, myocardial infarction, diabetes, hypercholesterolemia, type of MCI, education level and sex. These results support the hypothesis that reported use of amlodipine in MCI reduced the risk of incident dementia. <i>The NACC database is funded by NIA/NIH Grant U24 AG072122. NACC data are contributed by the NIA-funded ADRCs: P30 AG062429 (PI James Brewer, MD, PhD), P30 AG066468 (PI Oscar Lopez, MD), P30 AG062421 (PI Bradley Hyman, MD, PhD), P30 AG066509 (PI Thomas Grabowski, MD), P30 AG066514 (PI Mary Sano, PhD), P30 AG066530 (PI Helena Chui, MD), P30 AG066507 (PI Marilyn Albert, PhD), P30 AG066444 (PI John Morris, MD), P30 AG066518 (PI Jeffrey Kaye, MD), P30 AG066512 (PI Thomas Wisniewski, MD), P30 AG066462 (PI Scott Small, MD), P30 AG072979 (PI David Wolk, MD), P30 AG072972 (PI Charles DeCarli, MD), P30 AG072976 (PI Andrew Saykin, PsyD), P30 AG072975 (PI David Bennett, MD), P30 AG072978 (PI Neil Kowall, MD), P30 AG072977 (PI Robert Vassar, PhD), P30 AG066519 (PI Frank LaFerla, PhD), P30 AG062677 (PI Ronald Petersen, MD, PhD), P30 AG079280 (PI Eric Reiman, MD), P30 AG062422 (PI Gil Rabinovici, MD), P30 AG066511 (PI Allan Levey, MD, PhD), P30 AG072946 (PI Linda Van Eldik, PhD), P30 AG062715 (PI Sanjay Asthana, MD, FRCP), P30 AG072973 (PI Russell Swerdlow, MD), P30 AG066506 (PI Todd Golde, MD, PhD), P30 AG066508 (PI Stephen Strittmatter, MD, PhD), P30 AG066515 (PI Victor Henderson, MD, MS), P30 AG072947 (PI Suzanne Craft, PhD), P30 AG072931 (PI Henry Paulson, MD, PhD), P30 AG066546 (PI Sudha Seshadri, MD), P20 AG068024 (PI Erik Roberson, MD, PhD), P20 AG068053 (PI Justin Miller, PhD), P20 AG068077 (PI Gary Rosenberg, MD), P20 AG068082 (PI Angela Jefferson, PhD), P30 AG072958 (PI Heather Whitson, MD), P30 AG072959 (PI James Leverenz, MD).</i>