132EFFECTS OF DIURETICS ON COGNITIVE FUNCTIONS IN PATIENTS DIAGNOSED WITH DEMENTIA

Abstract

Introduction: The literature regarding effects of antihypertensive medication on cognition is infused by controversy. Our objective was to examine the effect of antihypertensive medication as associated with specific anti-dementia medication on cognitive functioning: memory (MMSE, Clock Drawing Test), functionality (ADL, IADL), behaviour disorders (NPI-Q: Neuropsychiatric Inventory Questionnaire) and global deterioration (GDS Test -Reisberg) in time. Method(s): A randomized longitudinal study of 165 patients (67.3% female, mean age 78.08, SD 7.67) diagnosed with all types of dementia in all stages. Patients were divided in 4 groups by anti-dementia therapy type: acetylcholinesterase inhibitors (ACheI), Nmethyl- D-aspartate receptor antagonists (NMDA), a combination of ACheI and NMDA (C), or no therapy (N). 135 patients had anti-hypertensive therapy from which 34 had diuretics (all types). Data were collected at inclusion (T1) and at 3 (T2), 6 (T3), 12 (T4), and 18 months (T5). Result(s): Diuretics were the only antihypertensive medication associated to MMSE score changes in time. Specifically, administering diuretics was correlated to MMSE scores indicative of cognitive deterioration between T1-T5 (r = -0,20, p < .05) and T4-T5 (r = -0,21, p < .05). The mean decrease in MMSE scores between T4-T5 was 0,83 units within the group without diuretics and 1,16 units within the group with diuretics. Antidementia therapy type was associated to a change in time of the cognitive scores in patients that received diuretics: the smallest change in MMSE scores was a decrease by 0,5 units within the combined treatment group (C), the most significant decrease in MMSE scores was for the group with no specific dementia treatment between T4-T5 (by 1,5 units). Diuretic treatment was not significantly associated to the other cognitive functions that were tested. Conclusion(s): Diuretics had an overall negative effect on memory (as evidenced by lower MMSE scores) among patients diagnosed with dementia.