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A new study published in the scientific journal Alzheimer’s & Dementia has tested whether tadalafil, an active ingredient in erectile dysfunction medication, may be effective in treating people with vascular dementia.

Everyday Health reports that the phase II trial, which is being led by researchers at St George’s, University of London and St George’s Hospital, is being funded by the Alzheimer’s Drug Discovery Foundation in the US and the UK Alzheimer’s Society.

The trial consisted of testing whether tadalafil caused an increase in blood flow to the brain in older men and women with a narrowing of the brain Cartier’s, a condition that can cause strokes and vascular dementia.

Although the trial results found no significant increase in blood flow, the researchers found clues pointing towards a potential use of tadalafil in treating certain patients, warranting further investigation.

Dementia is rapidly becoming a global healthcare crisis and has been estimated to affect 55 million globally, and is predicted to increase to 139 million by 2050.

There are currently few drug options available for patients, and the trial explored whether existing drugs, such as tadalafil, have the potential for treating vascular dementia.

A computational analysis identified drugs commonly used to increase blood flow to the penis in erectile dysfunction cases, such as sildenafil and vardenafil, as well as those commonly used for treating pulmonary hypertension as possible candidates for delaying or preventing dementia.

Tadalafil belongs to the same group of drugs, and the researchers hypothesise that the mechanisms that increase blood flow in other parts of the body, may also apply in the brain – providing brain cells with a healthier blood supply and reducing dementia symptoms.

Tadalafil was selected as the drug candidate for the trial because of its longer half-life (remaining in the bloodstream for longer) and evidence that it is better able to enter the brain than its related drugs.

The trial compared a single dose of tadalafil with a placebo, recording brain blood flow using an MRI-based method called arterial spin labelling, which traces blood flow without the need for radioactive tracers.

The investigators did not detect a significant difference in blood flow between those given tadalafil and those given a placebo.

However, the results showed a trend for increased blood flow in older participants (those over 70) in the brain’s white matter, which is the area most important for vascular dementia.

No serious adverse events were recorded during the trial.

The research team believe that further investigation of tadalafil needs to be considered to explore its effectiveness in older age groups over a longer time period.

Dr Jeremy Isaacs, the principal clinical investigator on the trial and consultant neurologist at St George’s Hospital, said that narrowing of the brain arteries is a common contributor to cognitive decline in older people and currently has no treatment, and this was a landmark study in which the team attempted to reverse the reception in brain blood flow characteristic of the condition.

“Although we did not find a significant effect following a single dose of tadalafil, we can’t rule out the possibility of benefits from longer-term use, for which further research is needed.”

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