Nonsteroidal antiinflammatory drugs and the risk of Alzheimer's disease
Nonsteroidal antiinflammatory drugs and the risk of Alzheimer's disease
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DOI：
10.1056/nejmoa010178
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发表时间：
2001-11-22
影响因子：
158.5
通讯作者：
Stricker, BHC
中科院分区：
文献类型：
--
作者：
in 't Veld, BA;Ruitenberg, A;Stricker, BHC
背景：以前的研究表明，使用非甾体类抗炎药（NSAID）可能有助于预防阿尔茨海默病。结果，然而，一直unaccepted.Methods：我们研究了使用非甾体抗炎药和阿尔茨海默病和血管性痴呆之间的关联在一个前瞻性的，以人群为基础的队列研究6989例受试者55岁或以上谁是免费的痴呆基线。阿尔茨海默病的风险是根据药房记录中记录的NSAID的使用来估计的。我们定义了四种相互排斥的用途：不使用、短期使用（累积使用1个月或更短）、中期使用（累积使用超过1个月但小于24个月）和长期使用（累积使用24个月或更长）。通过考克斯回归分析对年龄、性别、教育程度、吸烟状况、使用或不使用水杨酸盐、组胺H（sub 2）受体拮抗剂、抗高血压药和降血糖药进行调整。在平均6.8年的随访期间，394名受试者患上了痴呆症，其中293人患有阿尔茨海默病，56人患有血管性痴呆，和45种其他类型的痴呆症。阿尔茨海默病的相对风险在短期使用NSAID的受试者中为0.95（95%置信区间，0.70至1.29），在中期使用的受试者中为0.83（95%置信区间，0.62至1.11），在长期使用的受试者中为0.20（95%置信区间，0.05至0.83）。风险并不因年龄而异。非甾体抗炎药的使用与血管性痴呆的风险降低无关。结论：非甾体抗炎药的长期使用可预防阿尔茨海默病，但不能预防血管性痴呆。（N Engl J Med 2001;345：1515-21.）版权所有（C）2001马萨诸塞州医学会。
Background: Previous studies have suggested that the use of nonsteroidal antiinflammatory drugs (NSAIDs) may help to prevent Alzheimer's disease. The results, however, have been 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. 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 H(sub 2)-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. (N Engl J Med 2001;345:1515-21.) Copyright (C) 2001 Massachusetts Medical Society.