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Title: No advantage of Aβ 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies
Authors: Szekely, C.A.
Green, R.C.
Breitner, J.C.S.
Østbye, T. 
Beiser, A.S.
Corrada, M.M.
Dodge, H.H.
Ganguli, M.
Kawas, C.H.
Kuller, L.H.
Psaty, B.M.
Resnick, S.M.
Wolf, P.A.
Zonderman, A.B.
Welsh-Bohmer, K.A.
Zandi, P.P.
Issue Date: 10-Jun-2008
Citation: Szekely, C.A., Green, R.C., Breitner, J.C.S., Østbye, T., Beiser, A.S., Corrada, M.M., Dodge, H.H., Ganguli, M., Kawas, C.H., Kuller, L.H., Psaty, B.M., Resnick, S.M., Wolf, P.A., Zonderman, A.B., Welsh-Bohmer, K.A., Zandi, P.P. (2008-06-10). No advantage of Aβ 42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies. Neurology 70 (24) : 2291-2298. ScholarBank@NUS Repository.
Abstract: Introduction: Observational studies show reduced incidence of Alzheimer dementia (AD) in users of nonsteroidal anti-inflammatory drugs (NSAIDs). One hypothesis holds that the subset of NSAIDs known as selective Aβ 42-lowering agents (SALAs) is responsible for this apparent reduction in AD risk. Methods: We pooled individual-level data from six prospective studies to obtain a sufficient sample to examine AD risk in users of SALA vs non-SALA NSAIDs. Results: Of 13,499 initially dementia-free participants (70,863 person-years), 820 developed ncident AD. Users of NSAIDs (29.6%) showed reduced risk of AD (adjusted hazard ratio [aHR] 0.77, 95% CI 0.65-0.91). The point estimates were similar for SALAs (aHR 0.87, CI 0.72-1.04) and non-SALAs (aHR 0.75, CI 0.56-1.01). Because 573 NSAID users (14.5%) reported taking both a SALA and non-SALA, we examined their use alone and in combination. Resulting aHRs were 0.82 (CI 0.67-0.99) for SALA only, 0.60 (CI 0.40-0.90) for non-SALA only, and 0.87 (CI 0.57-1.33) for both NSAIDs (Wald test for differences, p = 0.32). The 40.7% of participants who used aspirin also showed reduced risk of AD, even when they used no other NSAIDs (aHR 0.78, CI 0.66-0.92). By contrast, there was no association with use of acetaminophen (aHR 0.93, CI 0.76-1.13). Conclusions: In this pooled dataset, nonsteroidal anti-inflammatory drug (NSAID) use reduced the risk of Alzheimer dementia (AD). However, there was no apparent advantage in AD risk reduction for the subset of NSAIDs shown to selectively lower Aβ 42, suggesting that all conventiona NSAIDs including aspirin have a similar protective effect in humans. Copyright © by AAN Enterprises, Inc.
Source Title: Neurology
ISSN: 00283878
DOI: 10.1212/01.wnl.0000313933.17796.f6
Appears in Collections:Staff Publications

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