Anticoagulant Therapy for Alzheimer's Disease: A Review of Recent Research

Abstract

Alzheimer's disease (AD) is a neurodegenerative, vascular, and hemostatic disease characterized by cerebral-amyloid angiopathy (CAA). Thrombin, fibrin, and amyloid-(Aβ) toxic proteins are important initiators of vascular anomalies and resulting neurodegeneration in AD, which can be managed with anticoagulants, as this article reviews. Recent research suggests that the pathophysiology of AD is influenced by risk factors for cardiovascular disease, dysregulated intrinsic coagulation, and cerebrovascular damage. Anticoagulants may be a viable treatment option for AD patients with vascular condition cognitive impairment. This article provides a thorough analysis of recent research, demonstrating that anticoagulant-particularly those of the direct oral anticoagulants (DOAC) type-may be able to combat the vascular-driven progression of AD-related neuroinflammation and CAA, given complete cerebral perfusion and a decreased milieu that accumulates fibrin and Aβ. When administered early, either therapeutically or prophylactically, DOAC may be more effectively utilized to reduce inflammation and vascular dysfunction due to pharmacological reasons. Preclinical research in AD animal models will be the first step in determining whether this treatment strategy can actually effectively combat the cerebral-vascular dysfunction that are a component of AD etiology.