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Non-Steroidal Anti-Inflammatory Drug (NSAID) Use and Alzheimer Disease in Community-Dwelling Elderly Patients

Received August 23, 2002; revised October 15, November 4, 2002; accepted November 4, 2002. From the Department of Gerontology–Geriatric and Physiatric, Catholic University of the Sacred Heart, Rome, Italy (FL,MC,GO,AR,ST,RB) and the Sticht Center on Aging, Wake Forest University–Baptist Medical Center, Winston-Salem, NC, U.S.A. (MC,GO). Address correspondence to Dr. Landi, Istituto di Medicina Interna e Geriatria, Centro Medicina dell'Invecchiamento (CE.M.I.), Universita' Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy. e-mail: francesco_landi{at}rm.unicatt.it

OBJECTIVE: Recently, greater attention has been paid to the role of inflammatory processes in the pathophysiology of Alzheimer disease (AD). However, the mechanism by which anti-inflammatory agents (NSAIDs) might slow the progression of AD is not completely known. The aim of the present study was to examine the relationship between NSAIDs use and AD in a large sample of community-dwelling elderly people. METHODS: In a cross-sectional retrospective study, the authors analyzed data on patients admitted to home care programs. A total of 12 home health agencies participated in the project, with a total of 2,708 patients enrolled in the present study. The main outcome measures were the prevalence of AD and use of NSAIDs treatment. RESULTS: Compared with all non-users, NSAID users had a nearly 50% lower risk of being affected by AD. Separate multivariate analyses of subjects receiving different types of NSAIDs found a significantly decreased risk of cognitive impairment associated with non-aspirin NSAID use, whereas, among subjects taking aspirin, the difference in estimated risk did not reach statistical significance. CONCLUSION: The results of this population-based cross-sectional study are consistent with the notion that long-term NSAIDs use has a protective effect against AD. However, after possible confounding effects of age and several other variables potentially associated with cognitive impairment were controlled, this association was statistically significant only for non-aspirin NSAIDs use.

Key Words: Alzheimer Disease • Epidemiology • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

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