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Nonsteroidal Antiinflammatory Drugs and the Risk of Alzheimer's Disease
Open accessAbstract
BACKGROUND: Previous studies have suggested that the use of nonsteroidal antiinflammatory drugs (NSAIDs) may help to prevent Alzheimer's disease. The results, however, are inconsistent. METHODS: We studied the association between the use of NSAIDs and Alzheimer's disease and vascular dementia in a prospective, population-based cohort study of 6989 subjects 55 years of age or older who were free of dementia at base line, in 1991. To detect new cases of dementia, follow-up screening was performed in 1993 and 1994 and again in 1997 through 1999. The risk of Alzheimer's disease was estimated in relation to the use of NSAIDs as documented in pharmacy records. We defined four mutually exclusive categories of use: nonuse, short-term use (1 month or less of cumulative use), intermediate-term use (more than 1 but less than 24 months of cumulative use), and long-term use (24 months or more of cumulative use). Adjustments were made by Cox regression analysis for age, sex, education, smoking status, and the use or nonuse of salicylates, histamine Hz-receptor antagonists, antihypertensive agents, and hypoglycemic agents. RESULTS: During an average follow-up period of 6.8 years, dementia developed in 394 subjects, of whom 293 had Alzheimer's disease, 56 vascular dementia, and 45 other types of dementia. The relative risk of Alzheimer's disease was 0.95 (95 percent confidence interval, 0.70 to 1.29) in subjects with short-term use of NSAIDs, 0.83 (95 percent confidence interval, 0.62 to 1.11) in those with intermediate-term use, and 0.20 (95 percent confidence interval, 0.05 to 0.83) in those with long-term use. The risk did not vary according to age. The use of NSAIDs was not associated with a reduction in the risk of vascular dementia. CONCLUSIONS: The long-term use of NSAIDs may protect against Alzheimer's disease but not against vascular dementia.
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“The recognition that a robust inflammatory response contributes to AD also fuelled the discovery that long-term treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) reduced the risk for AD, delayed disease onset, and slowed cognitive decline (McGeer et al., 1996;Stewart et al., 1997;in t' in t'Veld et al., 2001).”
From PPARγ/RXRα-Induced and CD36-Mediated Microglial Amyloid-β Phagocytosis Results in Cognitive Improvement in Amyloid Precursor Protein/Presenilin 1 Mice (2012) · cites this paper as in t'Veld et al., 2001
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Rommy von Bernhardi, M., Ramírez, G., Toro, R., & Eugenín, J. L. (2006) · Neurobiology of Disease · doi:10.1016/j.nbd.2006.12.006 · Cited by 51
Ma, S. L., Tang, N. L. S., Zhang, Y. P., Ji, L., Tam, C. W. C., Lui, V. W.-C., Chiu, H. F. K., & LAM, L. C. W. (2007) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2006.12.011 · Cited by 50
Prade, E., Barucker, C., Sarkar, R., Althoff-Ospelt, G., del Amo, J. M. L., Hossain, S., Zhong, Y., Multhaup, G., & Reif, B. (2016) · Biochemistry · doi:10.1021/acs.biochem.5b01272 · Cited by 50
Icariin targets Nrf2 signaling to inhibit microglia-mediated neuroinflammation
Zheng, Y., Zhu, G., He, J., Wang, G., Li, D., & Zhang, F. (2019) · International Immunopharmacology · doi:10.1016/j.intimp.2019.05.033 · Cited by 50
Microglial expression of prostaglandin EP3 receptor in excitotoxic lesions in the rat striatum
Slawik, H. C. (2004) · Neurochemistry International · doi:10.1016/j.neuint.2004.04.007 · Cited by 50
Jonker, C., Comijs, H. C., & Smit, J. H. (2003) · Neurobiology of Aging · doi:10.1016/s0197-4580(02)00188-4 · Cited by 48
Modulation of human microglia and THP-1 cell toxicity by cytokines endogenous to the nervous system
Klegeris, A., Bissonnette, C. J., & McGeer, P. L. (2004) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2004.06.012 · Cited by 54
Impact of the CD40-CD40L Dyad in Alzheimers Disease
Giunta, B. N., Rezai-Zadeh, K. P., & Tan, J. (2010) · CNS & Neurological Disorders - Drug Targets · doi:10.2174/187152710791012099 · Cited by 50
“The most compelling data come from epidemiologic studies showing that exposure to non-steroidal anti-inflammatory drugs (NSAIDs) is inversely associated with risk for AD [6–8].”
BackgroundZhao, D. F., Zhang, L. J., Huang, T., Kim, J., Gu, M., & Yang, H. O. (2021) · Phytomedicine · doi:10.1016/j.phymed.2021.153540 · Cited by 52
Drug-Induced Cognitive Impairment
Reimers, A., Odin, P., & Ljung, H. (2024) · Drug Safety · doi:10.1007/s40264-024-01506-5 · Cited by 58
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A Precision Medicine Model for Targeted NSAID Therapy in Alzheimer’s Disease
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Biegon, A. R., Alvarado, M., Budinger, T. F., et al. (2002) · Journal of Neurochemistry · doi:10.1046/j.1471-4159.2002.01050.x · Cited by 49
“…distribution of the PBN protective effect is highly reminiscent of the specific neuropathological lesions observed in AD and Parkinson’s disease and is supportive of recent observations of the efficacy of antioxidants in these diseases (Floyd and Carney 1996; Floyd et al. 2000; Veld et al. 2001).”
BackgroundNonsteroidal anti-inflammatory drugs and Alzheimer disease: what's next?
Launer, L. (2003) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.289.21.2865 · Cited by 37
Self-citationPan-PPAR Modulation Effectively Protects APP/PS1 Mice from Amyloid Deposition and Cognitive Deficits
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Protective effect of meloxicam-loaded nanocapsules against amyloid-β peptide-induced damage in mice
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Zhao, Y., Deng, H., Li, K., Wang, L., Wu, Y., Dong, X., Wang, X., Chen, Y., & Xu, Y. (2019) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2019.07.032 · Cited by 47
Metadata
- Authors
- in 't Veld, B. A., Ruitenberg, A., Hofman, A., Launer, L. J., van Duijn, C. M., Stijnen, T., Breteler, M. M. B., & Stricker, B. H. C.
- Affiliations
- Erasmus MC (NL)
- National Institutes of Health (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2001-11-22
- Volume
- 345
- Issue
- 21
- Pages
- 1515-1521
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2083556882
- Semantic Scholar
- 29c01ac52ec50618ec7b3b87ca55b707ca397434
- Cited by
- 1,196
- References
- 44
- Citations by year
- 2026: 13 · 2025: 14 · 2024: 18 · 2023: 23 · 2022: 26 · 2021: 33 · 2020: 23 · 2019: 40 · 2018: 38 · 2017: 28 · 2016: 40 · 2015: 49 · 2014: 49 · 2013: 39 · 2012: 50
- FWCI
- 52.61
- Type
- journal article
- Language
- en
- Open access
- green
- pure.eur.nl
- Licence
- other-oa
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pharmacology (medical) › Inflammatory mediators and NSAID effects
- Keywords
- nonsteroidal anti-inflammatory drugs, Alzheimer's disease, vascular dementia, dementia risk, long-term NSAID use, older adults
- MeSH terms
- Aged, Alzheimer Disease, Anti-Inflammatory Agents, Non-Steroidal, Drug Administration Schedule, Female, Humans, Male, Middle Aged, Prospective Studies, Risk, Salicylates, Dementia, Vascular, Cohort Studies, Proportional Hazards Models
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