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Aspirin and Dementia?

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dementia and older adultsI have asked our vice president for senior services, Steve Steiber, Ph.D. to share a guest posting about some recent research on a couple of blood thinners which have been found to be big risk factors for dementia. He has two decades experience in pharmaceutical and medical device consulting prior to joining CCM about 10 years ago.
Everyone has doubtless heard about taking low dose aspirin as protection against some heart complications, especially if a person has had a stent or other hardware implanted in their hearts. And most have also heard about the benefits of warfarin in patients prone to atrial fibrillation (AF) or coronary artery disease.
What some researchers had been seeing, however, was an apparently greater incidence of dementia in some of these patients, and they set out to determine if this was, in fact, the case and what could be done to reduce or eliminate the risk.
These researchers recruited more than a thousand AF patients with no history of dementia, but who were on a regimen including warfarin plus low dose aspirin or Plavix. The patients were followed for their blood levels of these medications over time and any diagnosable dementia, because they suspected that it would be the patients who strayed into higher blood levels who would be more at risk. (Warfarin is a drug they call a “narrow therapeutic index” drug which simply means that even very minor changes in blood levels of this drug can make a big difference in a person’s health.) What the doctors found was quite remarkable. Patients who trended about their target range of warfarin in the blood 25% or more of the time were twice as likely to develop dementia than those who were above their therapeutic range 10% or less of the time.
This is remarkable, because the patients who were above their target range actually had been well within their range fully 75 percent of the time. The researchers believe that the dementia may come from small bleeds in an area of the brain called the hippocampus that will precipitate the onset of dementia. And they offer some recommendations for anyone who may be a caregiver to an older loved one on this combination of warfarin and some other blood thinners like aspirin or Plavix. First, do not take the aspirin unless directed by the doctor. Second, take the lab tests ordered by the doctor regularly, because what can start as the right amount of medicine to be protected from clotting may not be appropriate as the patient’s body adjusts to the medication regimen. And, of course, never make any changes in your older loved one’s medication without consulting the physician prescribing those medications. Please let Steve know if you have any questions about drugs, their side effects or the unique medical challenges faced by older adults or others with special needs. Please email to: ssteiber@creativecaremanagement.com. Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to info@creativecaremanagement.com.

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