Newer Blood Thinners Linked to Slower Alzheimer's Decline — SkimNews
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- Karolinska Institutet researchers published a study in the European Heart Journal analyzing 7,308 people from Sweden's SveDem registry who were diagnosed with both atrial fibrillation and Alzheimer's disease.
- NOAC blood thinners were associated with slightly more than 0.2 MMSE points per year slower cognitive decline compared with warfarin or no anticoagulant treatment, measured via the Mini-Mental State Examination.
- Patients in the three-arm comparison were grouped into those receiving NOACs, those receiving the older warfarin (Waran), and those receiving no anticoagulant medication at all.
- NOAC users also showed lower risks of death, stroke, blood clots, and fractures compared with patients who received no anticoagulants.
- Warfarin was linked to lower risks of death, stroke, and blood clots but carried a higher risk of major bleeding than the newer NOACs.
- Maria Eriksdotter and Nanbo Zhu at Karolinska Institutet said the modest annual difference could compound meaningfully over longer periods, though the observational design cannot prove NOACs directly caused the slower decline.
- The researchers cautioned that some patients likely switched medications during follow-up, and unmeasured factors could have influenced both treatment choice and health outcomes.
Why it matters: For clinicians already choosing between anticoagulants for stroke prevention in older atrial fibrillation patients who also have Alzheimer's, the findings add a potential cognitive consideration favoring NOACs over warfarin, alongside NOACs' lower bleeding and fracture risk. However, the 0.2 MMSE-point annual difference is small and the study design cannot establish causation, so the finding supplements rather than replaces existing prescribing criteria.
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