Various studies have come up with a variety of answers to the question of whether regular use of NSAID drugs — ibuprofen, naproxen and others — might prevent or slow Alzheimer’s disease (AD) due to their potent anti-inflammatory properties. The results have mostly fallen somewhere between possibly and probably. Now we hear of a new study that suggests a different and very intriguing interpretation.
Researchers followed 2,736 dementia-free people age 65 and older for up to 12 years, during which time 476 developed dementia. Those who were “heavy” NSAID users (the equivalent of approximately six Advil per day) were 66% more likely to develop dementia, and 57% more likely to develop AD in particular. These puzzling statistics held true after the researchers controlled for other factors that might make people vulnerable to dementia — among them education, APOE gene status and diabetes.
I spoke with the study’s lead author, John Breitner, MD, MPH, of the VA Puget Sound Healthcare System and head of geriatric psychiatry at University of Washington School of Medicine, who told me that these findings are harder to interpret than they might seem. He believes that they might be due to the age of the sample population, rather than being a direct effect of the drug. In the previous studies showing that NSAID drugs may prevent AD, participants were typically younger — perhaps, he says, the drugs delayed onset of AD so instead of striking at, say, age 75, it held symptoms off for those taking NSAIDs until 85 or so.
The reason why most people in this age group take NSAID drugs is not for Alzheimer’s prevention, but to quell the discomfort of arthritis — a fact that raises the obvious question of whether something about arthritis might relate to the development of AD. Dr. Breitner says that his study and others have looked at that, and the answer seems to be no — it is apparently attributable to the drugs not the disease.
Dr. Breitner does not make any recommendations about use of these drugs based on this one study, cautioning that the information cannot yet be called authoritative. But, he adds, it would be a mistake to interpret the study data as a warning not to take NSAIDs. “These very useful drugs have known risks but taken appropriately, can also offer enormous benefits,” he said.
