Neurotherapeutics

, Volume 14, Issue 3, pp 784–791 | Cite as

Cilostazol Use Is Associated with Reduced Risk of Dementia: A Nationwide Cohort Study

  • Shu-Yu Tai
  • Chen-Yu Chien
  • Yu-Han Chang
  • Yuan-Han Yang
Original Article

Abstract

Whether antiplatelet agents have a preventive effect on cognitive function remains unknown. We examined the potential association between the use of cilostazol, an antiplatelet agent and cyclic adenosine monophosphate phosphodiesterase 3 inhibitor, and the risk of dementia in an Asian population. Patients initiating cilostazol therapy between 1 January 2004 and 31 December 2009 without a prior history of dementia were identified from Taiwan's National Health Insurance database. Participants were stratified by age, sex, comorbidities, and comedication. The outcome of interest was all-cause dementia (ICD-9-CM codes 290.0, 290.4, 294.1, 331.0). Cox regression models were used to estimate the hazard ratio (HR) of dementia. The cumulative cilostazol dosage was stratified by quartile of defined daily doses using no cilostazol use as a reference. A total of 9148 participants 40 years of age or older and free of dementia at baseline were analyzed. Patients using cilostazol (n = 2287) had a significantly decreased risk of incident dementia compared with patients not using the drug [n = 6861; adjusted HR (aHR) 0.75; 95% confidence interval (CI) 0.61–0.92]. Notably, cilostazol use was found to have a dose-dependent association with reduced rate of dementia emergence (p for trend = 0.001). Subgroup analysis identified a decline of dementia in cilostazol users with diagnosed ischemic heart disease (aHR 0.44, 95% CI 0.24–0.83) and cerebral vascular disease (aHR 0.34, 95% CI 0.21–0.54). These observations suggest that cilostazol use may reduce the risk to develop dementia, and a high cumulative dose further decreases the risk of dementia. These findings should be examined further in randomized clinical trials.

Key Words

Dementia cilostazol cohort studies 

Notes

Acknowledgments

This study was supported by grants from Kaohsiung Medical University Hospital (KMUH103-3R68 and KMUH105-5R64), the Ministry of Science and Technology (MOST103-2314-B-037-004-MY3), and Research Center for Environmental Medicine, Kaohsiung Medical University (KMU-TP104A34), none of which have had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors are grateful for the assistance of the Statistical Analysis Laboratory, Department of Medical Research, Kaohsiung Municipal Ta-Tung Hospital.

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Compliance with Ethical Standards

Conflict of Interest

The authors have no conflict of interest to declare.

Supplementary material

13311_2017_512_MOESM1_ESM.doc (52 kb)
Table S1 (DOC 51 kb)
13311_2017_512_MOESM2_ESM.pdf (524 kb)
ESM 1 (PDF 524 kb)

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Copyright information

© The American Society for Experimental NeuroTherapeutics, Inc. 2017

Authors and Affiliations

  • Shu-Yu Tai
    • 1
    • 2
    • 3
    • 4
  • Chen-Yu Chien
    • 5
    • 6
    • 7
  • Yu-Han Chang
    • 8
  • Yuan-Han Yang
    • 9
    • 10
  1. 1.Department of Family Medicine, School of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiung CityTaiwan
  2. 2.Department of Family Medicine, Kaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung CityTaiwan
  3. 3.Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung CityTaiwan
  4. 4.Research Center for Environmental MedicineKaohsiung Medical UniversityKaohsiung CityTaiwan
  5. 5.Department of Otorhinolaryngology, School of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiung CityTaiwan
  6. 6.Department of Otorhinolaryngology, Kaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung CityTaiwan
  7. 7.Department of Otorhinolaryngology, Kaohsiung Municipal Hsiao-Kang HospitalKaohsiung Medical UniversityKaohsiung CityTaiwan
  8. 8.Management Offices, Kaohsiung Municipal Ta-Tung HospitalKaohsiung Medical UniversityKaohsiung CityTaiwan
  9. 9.Department of Neurology, Kaohsiung Municipal Ta-Tung HospitalKaohsiung Medical UniversityKaohsiung CityTaiwan
  10. 10.Department of Master’s Program in Neurology, Faculty of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiung CityTaiwan

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