Long Term Non-Steroidal Anti-Inflammatory Medication Use Correlates with a Lower Risk of Dementia
Neurodegenerative conditions are characterized by chronic inflammation. Does reducing that inflammation help? As researchers here note, studies attempting to find correlations between dementia risk and use of common anti-inflammatory medications have produced conflicting results. This study looks at the duration of use of anti-inflammatory medications and total dose over time, and finds that only consistent long term use is associated with a modestly reduced risk of dementia.
Non-steroidal anti-inflammatory (NSAID) medication could reduce dementia risk due to anti-inflammatory and possibly amyloid-lowering properties. However, the results of observational studies and short-term randomized-controlled trials have been inconsistent, and duration and dose-response relationships are still unclear. We included 11,745 dementia-free participants from the prospective population-based Rotterdam Study (59.5% female, mean age 66.2 years). NSAID use from 1991 was derived from pharmacy dispensing records, from which we determined cumulative duration and dose. We defined four mutually exclusive categories of cumulative use: non-use, short-term use (less then 1 month), intermediate-term use (between 1 and 24 months), and long-term use (longer than 24 months).
During an average follow-up period of 14.5 years, a total of 9,520 (81.1%) participants had used NSAIDs at any given time, and 2,091 participants developed dementia. Use of NSAIDs was associated with lower dementia risk for long-term users (hazard ratio, HR: 0.88), and a small increased risk with short-term use (HR 1.04) or intermediate-term use (HR: 1.04). The cumulative dose of NSAIDs was not associated with decreased dementia risk. Associations were somewhat stronger for long-term use of NSAIDs without known effects on amyloid-β than for amyloid-lowering NSAIDs (HR 0.79 versus 0.89).
Long-term NSAID use, but not cumulative dose, was associated with decreased dementia risk. This suggests that prolonged rather than intensive exposure to anti-inflammatory medication may hold potential for dementia prevention.