{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:23:44Z","timestamp":1792801424420,"version":"4.5.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:00:00Z","timestamp":1724284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To study the effects of benign prostatic hyperplasia treatments, namely: alpha-adrenergic receptor blockers, 5-alpha-reductase inhibitors and phosphodiesterase-5 inhibitors on the risk of Parkinson\u2019s disease, Alzheimer\u2019s disease and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>All male Medicare enrollees aged 65 or above who were diagnosed with benign prostatic hyperplasia and received one of the study drugs between 2007\u20132020 were followed-up for the three outcomes. We used Cox regression analysis to assess the relative risk of each of the outcomes for each study drug compared to the most prescribed drug, tamsulosin, while controlling for demographic, socioeconomic and comorbidity factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results and conclusions<\/jats:title>\n                    <jats:p>The study analyzed 1.1 million patients for a mean follow-up period of 3.1 years from being prescribed one of the study drugs. For all outcomes, patients on tamsulosin were used as the reference for comparison. For mortality, alfuzosin was associated with 27% risk reduction (HR 0.73, 95%CI 0.68\u20130.78), and doxazosin with 6% risk reduction (HR 0.94, 95%CI 0.91\u20130.97). For Parkinson\u2019s disease, terazosin was associated with 26% risk reduction (HR 0.74, 95%CI 0.66\u20130.83), and doxazosin with 21% risk reduction (HR 0.79, 95%CI 0.72\u20130.88). For Alzheimer\u2019s disease, terazosin was associated with 27% risk reduction (HR 0.73, 95%CI 0.65\u20130.82), and doxazosin with 16% risk reduction (HR 0.84, 95%CI 0.76\u20130.92). Tadalafil was associated with risk reduction (27\u201340%) in all 3 outcomes. More research is needed to elucidate the underlying mechanisms of these observations. Given the availability of safer alternatives for treating benign prostatic hyperplasia, caution should be exercised when using tamsulosin in elderly patients, especially those with an increased risk of developing neurodegenerative diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0309222","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T14:33:50Z","timestamp":1724337230000},"page":"e0309222","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Tamsulosin use in benign prostatic hyperplasia and risks of Parkinson\u2019s disease, Alzheimer\u2019s disease and mortality: An observational cohort study of elderly Medicare enrollees"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0593-5377","authenticated-orcid":true,"given":"Kin Wah","family":"Fung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fitsum","family":"Baye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2077-4316","authenticated-orcid":true,"given":"Seo H.","family":"Baik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement J.","family":"McDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"issue":"4","key":"pone.0309222.ref001","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/bju.15229","article-title":"Benign prostatic hyperplasia\u2014what do we know?","volume":"127","author":"CM Devlin","year":"2021","journal-title":"BJU Int"},{"issue":"2","key":"pone.0309222.ref002","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.pop.2019.02.003","article-title":"Benign Prostatic Hyperplasia.","volume":"46","author":"RC Langan","year":"2019","journal-title":"Prim Care"},{"issue":"5 Suppl","key":"pone.0309222.ref003","first-page":"S122","article-title":"BPH: epidemiology and comorbidities.","volume":"12","author":"KT McVary","year":"2006","journal-title":"Am J Manag Care."},{"key":"pone.0309222.ref004","article-title":"Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline","author":"American Urological Association"},{"issue":"4","key":"pone.0309222.ref005","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1097\/JU.0000000000002183","article-title":"Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE PART I-Initial Work-up and Medical Management.","volume":"206","author":"LB Lerner","year":"2021","journal-title":"J Urol"},{"issue":"4","key":"pone.0309222.ref006","first-page":"181","article-title":"Alpha blockers for the treatment of benign prostatic hyperplasia.","volume":"9","author":"H. Lepor","year":"2007","journal-title":"Rev Urol"},{"issue":"2","key":"pone.0309222.ref007","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ucl.2021.12.003","article-title":"Medical Treatment of Benign Prostatic Hyperplasia.","volume":"49","author":"A Plochocki","year":"2022","journal-title":"Urol Clin North Am."},{"issue":"6","key":"pone.0309222.ref008","doi-asserted-by":"crossref","first-page":"3409","DOI":"10.1097\/MS9.0000000000002117","article-title":"Risk of Parkinson\u2019s disease among users of alpha-adrenergic receptor antagonists: a systematic review and meta-analysis","volume":"86","author":"P Lamichhane","year":"2024","journal-title":"Ann Med Surg (Lond)."},{"issue":"4","key":"pone.0309222.ref009","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1001\/jamaneurol.2020.5157","article-title":"Association of Glycolysis-Enhancing alpha-1 Blockers With Risk of Developing Parkinson Disease","volume":"78","author":"JE Simmering","year":"2021","journal-title":"JAMA Neurol"},{"issue":"11","key":"pone.0309222.ref010","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1002\/mds.29184","article-title":"Use of Glycolysis-Enhancing Drugs and Risk of Parkinson\u2019s Disease","volume":"37","author":"JE Simmering","year":"2022","journal-title":"Mov Disord"},{"issue":"10","key":"pone.0309222.ref011","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.1002\/mds.28712","article-title":"Exposure to Phosphoglycerate Kinase 1 Activators and Incidence of Parkinson\u2019s Disease","volume":"36","author":"P Gros","year":"2021","journal-title":"Mov Disord"},{"key":"pone.0309222.ref012","first-page":"131","article-title":"Parkinson disease among patients treated for benign prostatic hyperplasia with alpha1 adrenergic receptor antagonists","author":"R Sasane","year":"2021","journal-title":"J Clin Invest"},{"issue":"3","key":"pone.0309222.ref013","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1002\/pds.4361","article-title":"Tamsulosin and the risk of dementia in older men with benign prostatic hyperplasia.","volume":"27","author":"Y Duan","year":"2018","journal-title":"Pharmacoepidemiol Drug Saf."},{"issue":"4","key":"pone.0309222.ref014","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1517\/14728222.2012.664135","article-title":"Bioenergetics failure in neurodegenerative diseases: back to the future.","volume":"16","author":"U. 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