A SYSTEMATIC review of health records from over 130 million individuals has found that antibiotics, antivirals, vaccines , and anti-inflammatory medications are associated with a reduced risk of dementia, while some other medications, such as antipsychotics, are linked to increased risk.
Dementia remains a global public health challenge, with limited treatment options and an urgent need for more effective therapies. Leveraging existing medications as potential treatments offers a faster, cost-effective alternative to drug development. This study reviewed 14 studies that used large-scale administrative and medical records to explore the relationship between prescribed drugs for other conditions and dementia risk, including over 1 million dementia cases. By identifying patterns across drug classes, the researchers aimed to inform drug repurposing efforts for dementia prevention and treatment.
The methods involved a systematic review of studies employing a data-driven approach to analyse the link between prescribed medications and dementia. The pooled data included over 130 million individuals. Results revealed reduced dementia risk with the use of antimicrobials (antibiotics and antivirals), vaccines, and anti-inflammatory medications, consistent with the hypothesis that infections and inflammation contribute to dementia. Conversely, increased risk was associated with antipsychotics, diabetes medications, vitamins, and supplements. Results for antihypertensives and antidepressants were mixed. These findings highlight both opportunities and challenges in drug repurposing for dementia and stress the need for further research to clarify inconsistencies and identify specific biological mechanisms.
The findings have significant implications for clinical practice. Medications such as antimicrobials and vaccines, already widely used for other conditions, could potentially play a role in dementia prevention, especially in populations at high risk of cognitive decline. However, the varying effects observed among drug classes underscore the need for careful patient selection and further clinical trials. Future research should prioritise the exploration of biologically plausible drugs and their mechanisms to expedite their evaluation in adaptive platform trials for dementia. As evidence accumulates, these insights may help streamline the repurposing of safe, cost-effective treatments, accelerating their integration into clinical practice.
Katrina Thornber, EMJ
Reference
Underwood B. Data-driven discovery of associations between prescribed drugs and dementia risk: A systematic review. 2025;DOI:10.1002/trc2.70037.
