Alpha blocker and risk of dementia in patients with benign prostate hyperplasia: A nationwide population-based study using the National Health Insurance Service database
Jae Hyun Bae (1), Bum Sik Tae (1), Byeong Jo Jeon (1), Hoon Choi (1), Jae Young Park (1)
(1) Korea University Ansan Hospital, Ansan, South Korea
Recent study presented that use of tamsulosin increased risk of dementia in benign prostate hyperplasia (BPH) patients, but this study had limitations. We evaluated the association between alpha-blockers and dementia in patients with BPH.
Using the National Health Insurance Service database of the entire Korean adult patient population with BPH, data on alpha-blockers and dementia between January 2011 and December 2011 were analyzed. These patients were followed-up until September 2017. We tested the effect of alpha-blockers on the risk of dementia using propensity score-matched Cox proportional hazard regression models and Kaplan–Meier survival analysis.
During a mean follow-up period of 1,496 (±821.8) days, all inclusion and exclusion criteria were met by 65,481 patients with BPH. After propensity score-matching, the incidence of dementia was 18.5% in the tamsulosin cohort, 19.1% in the doxazosin cohort, 21.2% in the terazosin cohort, 18.0% in the alfuzosin cohort, and 21.3% in the no BPH medication cohort. The risk of dementia did not significantly differ between the tamsulosin cohort and the doxazosin [1.033 (0.961-1.111)] and alfuzosin [1.003 (0.925, 1.087)] cohorts. However, the no BPH medication [1.533 (1.384-1.699)] and terazosin [1.130 (1.064-1.201)] cohorts had a higher risk of dementia than the tamsulosin cohort. However, the risk of dementia was significantly lower in the BPH medication cohorts including terazosin than in the no BPH medication cohort.
The findings of this large population-based study indicate that BPH medication is not associated with risk of dementia either overall, by duration of use, or by type.