This site uses cookies to measure how you use the website so it can be updated and improved based on your needs and also uses cookies to help remember the notifications you’ve seen, like this one, so that we don’t show them to you again. If you could also tell us a little bit about yourself, this information will help us understand how we can support you better and make this site even easier for you to use and navigate.

Effects of centrally acting angiotensin converting enzyme inhibitors on functional decline in patients with Alzheimer’s disease


O'Caoimh, Rónán, Healy, Liam, Gao, Yang, Svendrovski, Anton, Kerins, David M., Eustace, Joseph, Kehoe, Patrick Gavin, Guyatt, Gordon, Molloy, D. William


Journal Of Alzheimer's Disease: JAD, Volume: 40, No.: 3, Pages.: 595-603

Year of Publication



Background: Centrally acting angiotensin converting enzyme inhibitors (CACE-Is) are associated with reduced rates of cognitive decline in patients with dementia. CACE-Is may also improve exercise tolerance in functionally impaired older adults with normal cognition, suggesting that CACE-Is may positively influence activities of daily living (ADL) in dementia.; Objective: To compare rates of decline in patients with mild to moderate Alzheimer’s disease (AD) receiving CACE-Is to those not currently treated with CACE-Is (NoCACE-I), included in the Doxycycline and Rifampicin for Alzheimer’s Disease study (n = 406).; Methods: Patients were included if baseline and end-point (twelve months apart) scores were available for measures including the Standardized Alzheimer’s Disease Assessment Scale – Cognitive Subscale; Quick Mild Cognitive Impairment screen; Clinical Dementia Rating Scale (CDR-SB), and Lawton-Brody ADL Scale.; Results: There was a significant, 25% difference (median one-point) in the 12-month rate of decline in ADL scores in patients taking CACE-Is (n = 91), compared to the NoCACE-I group (n = 274), p = 0.024. This remained significant after adjusting for age, gender, education, and blood pressure, p = 0.034. When individual CACE-Is were compared to the NoCACE-I group, a significant reduction in the rate of decline in ADLs (median one versus four points), were only observed for perindopril, p = 0.01. The CDR-SB was also reduced (median one-point) for the perindopril compared to the NoCACE-I group, p = 0.04.; Conclusion: This observational study suggests that CACE-Is, and potentially perindopril in particular, are associated with a reduced rate of functional decline in patients with AD, without an association with mood or behavior. This suggests that CACE-Is may slow disease progression in AD.;


ace inhibitors, acting, aged, aged, 80 and over, alzheimer disease, alzheimer’s disease, angiotensin, caceis, centrally, cognition disorders, cognitive, complications, converting, dementia, double-blind method, doxycycline, drug therapy, enzyme, etiology, female, function, humans, inhibitors, male, middle aged, neuropsychological tests, outcome assessment (health care), psychiatric status rating scales, psychological decline, retrospective studies, rifampin, therapeutic use

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Non randomised controlled trial

Type of Outcomes

ADLs/IADLs, Cognition

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions