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Painkillers May Not Protect Against Dementia
Date:4/22/2009

Contrary to prior research, study finds older people taking NSAIDs more likely to suffer decline

WEDNESDAY, April 22 (HealthDay News) -- Research has suggested that older people who want to avoid Alzheimer's disease might want to take daily doses of painkillers such as ibuprofen and naproxen, but a new study suggests that might not be the best idea.

"If people are thinking, 'Should I take these to prevent dementia?', the answer based on our study would be no," said study author Dr. Eric B. Larson, executive director of the Group Health Center for Health Studies in Seattle.

Still, he said, people who already take medications known as non-steroidal anti-inflammatory drugs (NSAIDs) for pain shouldn't stop using them.

Previous have shown that the drugs -- which also include aspirin, which wasn't included in this study -- seem to have the power to prevent Alzheimer's disease in some cases, although they don't seem to help people who already have the disease or those who develop it quickly.

The relationship between the drugs and Alzheimer's disease appears to be "more complex than was earlier believed," the study authors wrote.

The findings appear in the April 22 online issue of Neurology.

In their study, the Seattle team examined the medical records of more than 2,700 people aged 65 and older who were members of a Washington state medical insurance group as early as 1977. Ninety percent were white.

The researchers checked their usage of NSAIDs and found that 351 were heavy users -- defined as being prescribed at least 500 daily doses over a two-year period -- when they were enrolled in the study. Another 107 started using the medications heavily later on.

The drugs in question include ibuprofen (Advil), naproxen (Aleve) and others.

People who used the drugs extensively were 66 percent more likely to develop dementia than those who didn't, according to statistics that were adjusted to account for the number of participants with certain medical conditions, among other things.

The drugs themselves may not be the problem. Instead, Larson suggested, they could be a sign of chronic medical problems.

"The heavy users [of painkillers] had more diabetes, more arthritis, more signs of heart failure," he said. "It's very likely that what you're seeing is people using these medications because they're beginning to fail in their life."

Dr. Steven Vlad, an epidemiology and rheumatology researcher at Boston University School of Medicine, said the findings are "very much contrary to what a number of other studies have found, and I'm not sure how to fit them into previous research."

In the big picture, he said, "the practical, day-to-day utility of this study is small. We just don't know enough yet."

He agrees with Larson that people should not take the drugs purely to prevent Alzheimer's disease, especially since the medications pose risks of gastrointestinal ulcers, bleeding and kidney disease. "The big issue right now is we don't know how to balance the potential benefits against the known risks," Vlad said.

What to do? Larson said the best strategies to prevent dementia are the usual suspects -- regular exercise, control of blood pressure and no smoking. "These things are really common sense," he said. "Even in late life, they probably do benefit your brain from the standpoint of health."

More information

Learn more about NSAIDs from the American Academy of Orthopaedic Surgeons.



SOURCES: Eric B. Larson, M.D., MPH, executive director, Group Health Center for Health Studies, Seattle; Steven Vlad, M.D., epidemiology and rheumatology researcher, Boston University School of Medicine; April 22, 2009, Neurology, online


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