Elsevier

Mayo Clinic Proceedings

Volume 73, Issue 10, October 1998, Pages 951-955
Mayo Clinic Proceedings

Original Article
Nonsteroidal Anti-Inflammatory Drug Use and Alzheimer's Disease: A Case-Control Study in Rochester, Minnesota, 1980 Through 1984

https://doi.org/10.4065/73.10.951Get rights and content

Objective

To compare the frequency of use of nonsteroidal anti-inflammatory drugs (NSAIDs) among 302 incident cases of Alzheimer's disease (AD) and age- and sex-matched control subjects.

Design

We undertook a retrospective case-control study, using the resources of the Rochester Epidemiology Project.

Material and Methods

In ongoing studies of dementia in Rochester, Minnesota, we identified all incident cases of AD with onset between 1980 and 1984. From among all Rochester residents who received care at Mayo Clinic Rochester during those years, we selected one age- (within 3 years) and sex-matched control subject. For this study, exposure to a, prescription NSAID was defined as prescribed use for 7 or more days during the 2-year window of time encompassing the year of onset and the year before onset among cases and the corresponding index year and the year prior for control subjects.

Results

The odds ratio (OR) for exposure, as described, to a prescription NSAID versus no exposure to any NSAID was 0.79 (95% confidence interval \[CI), 0.45 to 1.38); the OR was 1.00 (95% CI, 0.52 to 1.92) for women and 0.40 (95% CI, 0.13 to 1.29) for men. Similarly, the overall OR for aspirin exposure versus no NSAID exposure was 0.90 (95% CI, 0.54 to 1.50).

Conclusion

These data are suggestive but not confirmatory of a protective effect of NSAIDs for AD.

Section snippets

Cases of AD and Control Subjects

During the performance of ongoing studies of dementing illness in Rochester, Minnesota, we identified persons with the onset of AD during the years 1980 through 1984.8 Health-care providers in Rochester are limited in number, and each provides diagnostic information and clinical details for the Rochester Epidemiology Project at Mayo Clinic Rochester.7 Although some cases of AD may not come to medical and diagnostic attention, we believe that scenario to be uncommon because more than 95% of the

Results

Among the 302 incident cases of AD with onset during the years 1980 through 1984 in Rochester, Minnesota, 152 (50%) had documentation of use of either prescription or nonprescription NASIDs during the 2-year time window described. Similarly, 161 of the 302 age- and sex-matched control subjects (53%) had evidence of exposure to either prescription or nonprescription NASIDs during the 2-year window described.

As noted in the Methods section, three categories of exposure to NASIDs were used in this

Discussion

Our findings failed to demonstrate a significant inverse association between use of NSAIDs and AD. Nevertheless, the point estimates of the OR were less than unity except for exposure to aspirin in men and prescription NSAIDs in women, a finding that could be interpreted as suggestive of a protective effect. The results of two studies 3,4 strongly suggest that NSAIDs are protective for AD. One of them, the Canadian Study of Health and Aging,4 used prevalent cases with age- and group-matched

Conclusion

Although our current study failed to confirm a protective effect of use of NSAIDs on AD, results from earlier investigations were equivocal as well Additional longitudinal studies of the use of NSAIDs in other populations are needed for further assessment of this potential association.

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    This study was supported in part by Research Grants AR 30582, NS 17750, AG 06786, and AG 08031 from the National Institutes of Health, Public Health Service.

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