Prostate Meds Slash Dementia Risk by up to 40 Percent: Study

Commonly prescribed alpha-blockers for treating benign prostatic hyperplasia may also offer protective effects against dementia with Lewy bodies.

Men taking alfuzosin, terazosin or doxazosin had a significantly lower risk of developing LBD compared to those taking tamsulosin or 5ARIs.fizkes/Shutterstock

A new study published in Neurology suggests that medications commonly prescribed for an enlarged prostate might also reduce the risk of developing dementia with Lewy bodies (LBD), a neurodegenerative disorder impacting memory, movement, and cognition.

The Study

Researchers from the University of Iowa and the University of Michigan investigated whether three prostate drugs—terazosin, doxazosin, and alfuzosin—might offer protective effects against dementia with Lewy bodies.

These commonly prescribed alpha-blockers are typically used to treat benign prostatic hyperplasia (BPH), a condition marked by an enlarged prostate. By relaxing the muscles in the prostate and bladder neck, these medications help alleviate symptoms such as frequent or painful urination.

Jacob Simmering, the study’s lead author and assistant professor in the division of pulmonary, critical care, and occupational medicine in the Department of Internal Medicine in the Carver College of Medicine, told The Epoch Times that previous research indicated these medications activate an enzyme involved in ATP production, which cells use for energy.

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“We theorized that the increased energy in the cell may help prevent the build-up of certain harmful proteins in the brain associated with dementia with Lewy bodies,” he said.

The researchers analyzed data from more than 600,000 men who began treatment with one of the three prostate drugs or with two other types of prostate medications—tamsulosin and 5α-reductase inhibitors (5ARIs).

“We identified men who were newly started on one of these three medications and a comparison group of men who were started on one of three other BPH medications,” Mr. Simmering said. “The other two medications are “thought to have no effect on dementia risk.”

The findings revealed that men taking terazosin, doxazosin, or alfuzosin had a significantly lower risk of developing LBD compared to those taking tamsulosin or 5ARIs. Specifically, the risk was 40 percent lower compared to tamsulosin and 37 percent lower compared to 5ARIs.

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“These results are exciting because right now there are no drugs to prevent or treat dementia with Lewy bodies, which is the second most common neurodegenerative type of dementia after Alzheimer’s disease,” Mr. Simmering said in a statement. “If we can determine that an existing drug can offer protection against this debilitating disease, that has the potential to greatly reduce its effects.”

While the results are promising, further research, including randomized controlled trials, must establish a causal relationship and confirm these benefits. If validated, these drugs could offer a low-cost and widely accessible treatment option for neurodegenerative diseases.

Potential Side Effects of Alpha-Blockers

In a paper published in Reviews in Urology, Dr. Herbert Leper describes alpha-blockers as “the most effective, least costly, and best tolerated” medications for relieving lower urinary tract symptoms.

According to the Urology Care Foundation, alpha-blockers are generally well-tolerated and fast-acting. However, due to their blood pressure-lowering effects, common side effects include dizziness, fatigue, and headaches. The most serious potential side effects are dangerously low blood pressure and fainting, particularly when starting the medication.

“The major side effect of concern is orthostatic hypotension,” Mr. Simmering said. Orthostatic hypotension is a sudden drop in blood pressure when standing up. These drugs were initially developed to treat high blood pressure.

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“They aren’t ‘great’ hypertension treatments and have been largely replaced by newer therapies,” he said. “The primary concern with orthostatic hypotension is an increased risk of falls.”

Additionally, some men may experience retrograde ejaculation, where semen enters the bladder instead of exiting through the penis during ejaculation. According to a 2021 study in the journal Fertility and Sterility, “Ejaculatory dysfunction has been noted to be a side effect of all alpha-blockers across numerous studies.”

Dementia With Lewy Bodies

Dementia with Lewy bodies is a progressive brain disorder marked by declines in cognition, movement, behavior, and mood. It is caused by abnormal deposits of the protein alpha-synuclein in the brain, known as Lewy bodies. These protein clumps disrupt the brain’s chemical balance, resulting in symptoms such as fluctuating cognition, visual hallucinations, mood disorders, and issues with autonomic functions such as blood pressure and temperature regulation.

The National Institute of Neurological Disorders and Stroke estimates that about 1 million Americans are affected by Lewy body dementia, which includes both dementia with Lewy bodies and Parkinson’s disease dementia.

“Diagnosing LBD can be challenging for a number of reasons,” they note. “Early LBD symptoms are often confused with similar symptoms found in other brain diseases.”

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Comedian Robin Williams was one of the most well-known individuals to suffer from LBD, highlighting the severe impact it can have on mental and physical health. Symptoms of LBD include hallucinations, impaired balance, stooped posture, and cognitive decline. It also affects sleep, causing issues such as excessive daytime sleepiness and insomnia. Behavioral changes, such as depression and anxiety, are also common.

Broader Implications of the Findings

Mr. Simmering emphasized the broader implications of these findings, noting the potential impact on treatment approaches for neurodegenerative diseases. He highlighted the extensive clinical experience and safety data associated with prostate medications like terazosin, doxazosin, and alfuzosin.

“One exciting thing about these prostate medications is that they are widely used for managing BPH and have been in use for decades. We have considerable safety data and clinical experience using these medications in elderly men and, to a lesser extent, elderly women,” Mr. Simmering told The Epoch Times.

The widespread use and established safety profile of these drugs could facilitate their repurposing for neurodegenerative conditions, potentially accelerating the availability of new treatments.

Additionally, this research mirrors previous research by Mr. Simmering on Parkinson’s disease, suggesting a shared mechanism. “If our hypothesized mechanism is true—that these medications increase energy levels in cells and reverse some of the age-related metabolic impairment—then this may offer a broad potential therapy for neurodegenerative diseases, as many share common features,” Mr. Simmering said.

Mr. Simmering pointed out that current therapies for neurodegenerative diseases are mainly symptom-focused. “Right now, our therapies for neurodegenerative diseases are limited and largely focused on treating symptoms. Finding neuroprotective therapies offers the potential to change that progression or prevent the disease in the first place,” he said.

If future studies confirm the neuroprotective effects of these prostate medications, it could lead to a significant shift in how conditions like dementia with Lewy bodies are managed.