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Analysis Supports Protective Effect of NSAID Use Against Alzheimer's Disease
By Anthony J. Brown, MD
NEW YORK (Reuters Health) Jul 17 - A new review of several observational studies provides further evidence that use of non-steroidal antiinflammatory drugs protects against the development of Alzheimer's disease.
Dr. Mahyar Etminan, from the Royal Victoria Hospital in Montreal, and colleagues conducted a meta-analysis of nine studies that investigated NSAID use in older adults. The findings are published in the July 19th issue of the British Medical Journal.
Overall, NSAID users were 28% less likely to develop Alzheimer's disease than nonusers, the investigators note. When the analysis was limited to aspirin use, the risk reduction was 13%.
The risk of Alzheimer's was inversely related to the duration of NSAID use. The risk fell by only 5% when these drugs were used for less than 1 month, while NSAID use for 2 or more years produced a 73% drop in the risk.
"We did find a statistically significant protective effect for NSAID use in general," Dr. Etminan told Reuters Health. "With aspirin, however, we found some benefit but it was not statistically significant. This may be because we didn't have enough studies to see a significant effect or because the aspirin doses used were too small."
"We think that it is probably the anti-inflammatory effects of NSAIDS that provide the protection," Dr. Etminan said. "A few studies have shown that NSAIDs bind to the amyloid plaques" seen in Alzheimer's disease.
Dr. Etminan noted that a randomized controlled trial is currently underway that should determine whether NSAIDs are protective against Alzheimer's disease and if this represents another indication for their use.
Once the disease has already set in, NSAIDs do not appear to be particularly beneficial. In a study released last month, NSAID use by patients with mild to moderate Alzheimer's did nothing to slow their cognitive decline (see Reuters Health report June 4, 2003).
BMJ 2003;327:128-131. |
