Does aspirin or other NSAIDs reduce the risk of cognitive decline in elderly persons? Results from a population-based study
Does aspirin or other NSAIDs reduce the risk of cognitive decline in elderly persons? Results from a population-based study
复制标题
DOI：
10.1016/s0197-4580(02)00188-4
复制
发表时间：
2003-07-01
影响因子：
4.2
通讯作者：
Smit, JH
中科院分区：
文献类型：
--
作者：
Jonker, C;Comijs, HC;Smit, JH
目的：要调查的保护作用，非甾体抗炎药和阿司匹林分别对老年人的认知能力下降，控制一致使用这些药物在一个较长的时间periods.Methods：研究样本包括1007名受试者，从人口为基础的随机抽样的老年人，62-85岁，谁参加了3年的随访研究。从该样本中选择确实使用NSAID并在两次测量时完成所有认知测试的受试者（n = 137）和未使用NSAID并完成所有认知测试的受试者（n = 475）。包括认知测试。简易精神状态检查（MMSE）、情景记忆测试（听觉语言学习测试）和信息处理速度测试（编码任务）。使用Edwards-Nunnally方法计算认知下降。进行了多元逻辑回归分析，以检查NSAID（联合或不联合阿司匹林）与认知能力下降之间的关系。结果：仅阿司匹林使用者经年龄、性别、教育程度、基线MMSE、血管疾病、糖尿病和（类风湿）关节炎校正后的情景记忆（即刻回忆）下降的相对危险度估计值降低3倍以上（OR：0.30，95%CI：0.09-0.82）。经年龄、性别、教育、基线MMSE、血管疾病、糖尿病和（类风湿性）关节炎校正后，使用NSAID而不使用阿司匹林的记忆力下降的比值比不显著（OR：1.00，95%CI：0.39-2.93）。阿司匹林的作用仅在75岁及以上的受试者中显著（OR：0.10，95% CI：0.01-0.81），而在75岁以下的受试者中不显著（OR：0.52，95% CI：0.14-1.96）。NSAID对信息处理速度没有好处。在92%的阿司匹林用户低剂量的100毫克或更少的每日used.Conclusion：低剂量阿司匹林可能是保护在个人的记忆力下降的75岁及以上。低剂量阿司匹林的益处不支持抗炎作用，但表明具有抗血小板作用。因此，低剂量阿司匹林对认知功能下降的可能保护作用可能仅适用于长期使用阿司匹林的受试者。(C)2002年爱思唯尔科技有限公司All rights reserved.
Objective: To investigate the protective effect of NSAIDs and aspirin separately on cognitive decline in elderly subjects, controlling for consistent use of these agents over a prolonged period of time.Methods: The study sample consisted of 1007 subjects, drawn from a population-based random sample of elderly individuals, 62-85 years old, who participated in a 3-year follow-up study. From this sample subjects were selected, who did use NSAIDs and completed all cognitive tests at both measurements (n = 137), and subjects who did not use NSAIDs and completed all cognitive tests (n = 475). Cognitive tests included. the Mini-Mental State Examination (MMSE), tests for episodic memory (Auditory Verbal Learning Test) and information processing speed (coding task). Cognitive decline was computed using Edwards-Nunnally method. Multiple logistic regression analyses were performed to examine the association between NSAID (with and without aspirin) and decline in cognitive performance. Besides, the interaction of NSAIDs with age on cognitive decline was determined.Results: The relative risk estimates of decline in episodic memory (immediate recall) adjusted for age, gender, education, baseline MMSE, vascular diseases, diabetes mellitus and (rheumatoid) arthritis for aspirin users only was more than three times reduced (OR: 0.30, 95% CI: 0.09-0.82). The odds ratio for decline in memory of NSAID use without aspirin, adjusted for age, gender, education, baseline MMSE, vascular diseases, diabetes mellitus and (rheumatoid) arthritis was not significant (OR: 1.00, 95% CI: 0.39-2.93). The effect of aspirin was significant only in persons of 75 years and over (OR: 0.10, 95 % CI: 0.01-0.81), not in subjects younger than 75 years (OR: 0.52, 95% CI: 0.14-1.96). NSAIDs did not have benefit on information processing speed. In 92% of aspirin users a low dose of 100 mg daily or less was used.Conclusion: Low-dose aspirin might be protective for decline in memory in individuals of 75 years and over. The benefit of a low-dose aspirin does not support an anti-inflammatory effect, but suggests an antiplatelet effect. Therefore, a possible protective effect of low-dose aspirin on cognitive decline is likely only in subjects with aspirin use over a prolonged period of time. (C) 2002 Elsevier Science Inc. All rights reserved.