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NSAIDs and Alzheimer's disease.

Several recent studies have suggested that nonsteroidal anti-inflammatory drugs (NSAIDs) provide protection against the development of Alzheimer's disease (AD). A meta-analysis of these studies supports this idea. While aspirin use was associated with a 13% risk reduction, NSAID use was associated with a 28% risk reduction. Duration of use was another important factor; use for 2 years or longer was associated with a 73% risk reduction.

The exact mechanism of action of these drugs in preventing AD is unclear. Anti-inflammatory effects may provide protection, although it has been proposed that NSAIDs may bind to amyloid plaques. The decreased efficacy of aspirin may be related to the doses noted in the analysis; larger doses may be needed.

It is still to soon to recommend NSAIDs as a means to prevent dementia. However, many people will take NSAIDs anyway until further studies provide definitive evidence. A randomized controlled trial is under way. In the interim, nurses can counsel patients about the potential benefits of NSAID use in preventing AD, with clear explanation that further study is needed. Of note is that the meta-analysis showed no benefit whatsoever of NSAID use once AD is evident.

Etminan, M., Gill. S., & Samii. A. {2003). Effect of nonsteroidal anti-inflammatory drugs on risk of alzheimer's disease: Systematic review and meta-analysis of observational studies. British Medical Journal, 327, 128-31.
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Title Annotation:Horizons
Publication:Journal of Neuroscience Nursing
Article Type:Brief Article
Date:Dec 1, 2003
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