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Correlation of alpha blocker with dementia in patients with benign prostate hyperplasia: A nationwide population-based study using the National Health Insurance Service database

  • Tae B.S. 1,
  • Jeon B.J. 1,
  • Choi H. 1,
  • Park J.Y. 1,
  • Cheon J. 2,
  • Lee J.G. 2,
  • Bae J.H. 1
1 Korea University Ansan Hospital, Dep. of Urology, Ansan, South Korea 2 Korea University Ansan Hospital, Dep. of Urology, Seoul, South Korea

Introduction & Objectives

To evaluate the association between alpha-blockers and dementia in patients with benign prostate hyperplasia (BPH).

Materials & Methods

Using the National Health Insurance Service database of the entire Korean adult patient population with BPH, data on alpha-blockers and dementia between January 2011 and December 2011 were analyzed. These patients were followed-up until September 2017. We excluded patients who were previously diagnosed with cognitive dysfunction or dementia, or who had a history of a cerebral event. We tested the effect of alpha-blockers on the risk of dementia using propensity score-matched Cox proportional hazard regression models and Kaplan–Meier survival analysis.

Results

During a mean follow-up period of 1,496 (±821.8) days, all inclusion and exclusion criteria were met by 65,481 patients with BPH. After propensity score-matching, the incidence of dementia was 18.5% in the tamsulosin cohort, 19.1% in the doxazosin cohort, 21.2% in the terazosin cohort, 18.0% in the alfuzosin cohort, and 21.3% in the no BPH medication cohort. The risk of dementia did not significantly differ between the tamsulosin cohort and the doxazosin [1.033(0.961-1.111)] and alfuzosin [1.003 (0.925, 1.087)] cohorts. However, the no BPH medication [1.533 (1.384-1.699)] and terazosin [1.130 (1.064-1.201)] cohorts had a higher risk of dementia than the tamsulosin cohort. However, the risk of dementia was significantly lower in the BPH medication cohorts including terazosin than in the no BPH medication cohort.

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Conclusions

The findings of this large population-based study indicate that the use of BPH medication is not associated with an increased risk of dementia either overall, by duration of use, or by type.