New study links erectile dysfunction meds to a reduced risk of dementia
Key Takeaways
A study conducted over 5 years linked the use of sildenafil and other erectile dysfunction medications to a reduced risk of developing dementia.
This is the second study that has linked the use of erectile dysfunction medications to a reduced risk of developing dementia.
There have been no clinical trials investigating this link.
A study published last week in Neurology found a link between the use of sildenafil (Viagra) and other phosphodiesterase type 5 inhibitors typically used to treat erectile dysfunction (ED) and a reduced risk of developing dementia. The study followed 269,725 men, with 1,119 newly diagnosed with Alzheimer’s disease (AD). Participants were all 40 years or older and were followed for five years. 55% of participants were prescribed erectile dysfunction medications, and 45% were not. Researchers found that the men prescribed the erectile dysfunction medications were 18% less likely to develop AD.[]
However, this study could not prove causation. Although it was able to look at some additional risk factors for dementia, including obesity and alcohol use, and analyze them along with data collected about ED medication use, the study could not account for all possible risk factors. For instance, it’s possible that factors such as increased physical or sexual activity among men using these medications also played a role in their decreased risk of developing dementia.
This study isn’t the first that has linked sildenafil to a lowered risk of developing dementia. In 2021, the National Institutes of Health looked at insurance records and found that men with diabetes or high blood pressure who used sildenafil and other ED medications experienced a 69% reduced risk of AD. Not all studies have produced similar results. A 2022 study conducted by Harvard University researchers found that ED medications were not associated with a protective effect against dementia.[]
Nearly all studies connecting sildenafil and similar medications to dementia have been observational. A test in mice found that phosphodiesterase type 5 inhibitors had neuroprotective effects, but no similar tests have been conducted on humans. Additional studies are needed before any conclusions can be drawn.[]
“The thing with these studies is that they’re all observational,” says Ian Maidment, clinical pharmacist, Director of Pharmaceutical and Clinical Pharmacy Research, and Associate Director of the Post-Graduate Psychiatric Pharmacy Program at Aston University, says. “There’s no clinical data to go with this. What’s needed now is clinical trials, so we can really see what’s here. Then there will be data that might back this up—or it might not.”
Sildenafil was initially developed for the treatment of high blood pressure and chest pain due to heart disease. It works by relaxing arteries and blood vessels, improving blood flow throughout the body. During clinical trials, participants have reported its effects on erections and sexual functions. The United States Food and Drug Administration (FDA) approved it for the treatment of ED in 1998. Currently, the medication is also approved for treating pulmonary arterial hypertension.[]
Viagara’s potential benefits for other conditions are being studied. The Holden Comprehensive Cancer Center at the University of Iowa is conducting clinical trials to see if sildenafil, the generic name for Viagra, could be beneficial as part of smoking cessation treatment plans. At the University of Pennsylvania, researchers are conducting tests to see if sildenafil can lessen cerebrovascular dysfunction linked to traumatic brain injuries.[][]
The future of dementia treatment
The Centers for Disease Control and Prevention (CDC) estimates that around 5 million Americans over the age of 65 have dementia. By 2060, this number is predicted to grow to almost 14 million. Despite some advances in the last several years, there’s still no cure or way to prevent dementia.[]
Current treatments for dementia include the medication lecanemab, an anti-amyloid treatment that can remove beta-amyloid proteins from the brain during early-stage Alzheimer’s. The goal of anti-amyloid treatments is to slow the progression of dementia. Another anti-amyloid, aducanumab, has also received FDA approval for the treatment of early-stage Alzheimer’s. However, Biogen, the company that manufactures aducanumab, will discontinue the medication in 2024.[]
Other treatments target the symptoms of dementia; they include medications that improve memory, cognition, and communication, such as cholinesterase inhibitors and glutamate regulators. Additional treatments, including anti-psychotics, help manage behavioral and psychological symptoms associated with dementia, such as insomnia and agitation.
“Right now, our best options are really prevention,” says Dr. Maidment. “We don’t have effective pharmaceutical treatments yet, but we do know that there are things you can do to lower your risk. So that’s a good place to focus.”
New treatments might be on the horizon. Anti-amyloids only gained FDA approval in 2020 and are not yet used worldwide. Research into many other promising treatments, including clinical studies, is always ongoing. Other anti-amyloids are currently in phase three of clinical trials. If approved, these medications could fill the gap left by the discontinuation of aducanumab. Additional treatments with potential neuroprotective elements that aim to slow the progression of dementia are also in phase three clinical trials.[]
“There are over 100 medications in trials,” Dr. Maidment says. “Many of those won’t be successful, but some of them could be. There’s a lot of work being done by a lot of people.”