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Is Tamsulosin Linked to Dementia in the Elderly?

  • Benign Prostatic Hyperplasia (K McVary, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Lower urinary tract symptoms (LUTS) result from age-related changes in detrusor function and prostatic growth that are driven by alterations in the ratio of circulating androgens and estrogens. Alpha-adrenergic receptor blockers are commonly used to treat LUTS because they influence urethral tone and intra-urethral pressure. Molecular cloning studies have identified three α1-adrenergic receptor subtypes (α1A, α1B, and α1D). The α1A subtype is predominant in the human prostate but is also present in many parts of the brain that direct cognitive function. Tamsulosin is the most widely used α1-adrenergic receptor antagonist with 12.6 million prescriptions filled in 2010 alone. When compared to the other common types of α1-adrenergic receptor antagonists (i.e., terazosin, doxazosin, and alfuzosin), tamsulosin is 10- to 38-fold more selective for the α1A versus the α1B subtype.

Recent Findings

Duan et al. have recently shown that men taking tamsulosin have a higher risk of developing dementia when compared to men taking other α-adrenergic antagonists or no α-adrenergic antagonists at all (HR 1.17; 95% CI 1.14–1.21).

Summary

Based upon this retrospective analysis, we believe that tamsulosin, because of its unique affinity for α1A-adrenergic receptors, may increase the risk of developing dementia when used for an extended period of time. If these findings are confirmed, they carry significant public health implications for an aging society.

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Authors and Affiliations

  1. Department of Surgery, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030-8073, USA

    Jason K. Frankel & Peter C. Albertsen

  2. Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA

    Yinghui Duan

Authors
  1. Jason K. Frankel
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  2. Yinghui Duan
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  3. Peter C. Albertsen
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Correspondence to Peter C. Albertsen.

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Jason K. Frankel, Yinghui Duan, and Peter C. Albertsen each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Benign Prostatic Hyperplasia

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Frankel, J.K., Duan, Y. & Albertsen, P.C. Is Tamsulosin Linked to Dementia in the Elderly?. Curr Urol Rep 19, 69 (2018). https://doi.org/10.1007/s11934-018-0821-0

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  • DOI: https://doi.org/10.1007/s11934-018-0821-0

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