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Journal Article Ppublish

PubMed: 40356023 DOI: 10.1002/alz.70213

Association between the use of levodopa/carbidopa, Alzheimer's disease biomarkers, and cognitive decline among participants in the National Alzheimer's Coordinating Center Uniform Data Set.

Alzheimers Dement 21(5):e70213

Authors: Zsuzsa Sárkány, Joana Damásio, Sandra Macedo-Ribeiro, Pedro M Martins

Affiliations

  • i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
  • IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal.
  • Centro de Genética Preditiva e Preventiva (CGPP), IBMC Universidade do Porto, Porto, Portugal.
  • Neurology Department, Centro Hospitalar Universitário de Santo António, ULS de Santo António, Porto, Portugal.
  • ICBAS School of Medicine and Biomedical Sciences, Universidade do Porto, Porto, Portugal.

Abstract

INTRODUCTION

This retrospective study investigates whether exposure to levodopa/carbidopa (LA/CA) medication is associated with modified Alzheimer's disease (AD) trajectories.

METHODS

Multivariate analysis used cerebrospinal fluid (CSF) biomarker information included in the National Alzheimer's Coordinating Center Uniform Data Set for subjects with normal cognition (NC), mild cognitive impairment (MCI), and dementia (DE). Survival analyses examined the progression to MCI/DE and death events.

RESULTS

LA/CA use is associated with lower levels of CSF amyloid beta, phosphorylated-tau (p-tau) and total-tau. After adjusting for age, sex, and apolipoprotein E (APOE) ε4 allele presence, that effect was quantified by negative coefficients of the fitted linear mixed models: p-values < 0.01 in all cases except for p-tau in the MCI subgroup (p = 0.02). No similar effects were identified for other antiparkinsonians. Exposure to LA/CA decreased the progression from MCI to DE (p = 0.03).

DISCUSSION

The identified association between LA/CA exposure, AD biomarkers, and progression deserves further investigation in controlled clinical trials.

HIGHLIGHTS

LA/CA is associated with lower levels of CSF biomarkers for AD. This effect is not observed when other antiparkinsonian drugs are used. LA/CA is also associated with delayed progression to dementia by AD patients with MCI.

MeSH

Dementia, Alzheimer Disease, Cognitive Dysfunction, Dopamine, Biomarkers, Carbidopa, Levodopa

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