Anti-inflammatory drugs do not improve cognitive function in older adults

Inflammatory processes may play a role in Alzheimer’s disease and other neurodegenerative disorders, as well as in the decline of cognitive (thinking, learning and memory) function in older adults, according to background information in the article. “Consistent with this hypothesis, observational studies have shown an association between the use of non-steroidal anti-inflammatory drugs (NSAIDs) and a lower risk of Alzheimer’s disease,” the authors write.

The ADAPT (Alzheimer’s Disease Anti-Inflammatory Prevention Trial) Research Group conducted a randomized clinical trial involving 2,117 individuals age 70 and older with a family history of Alzheimer’s disease. From March 2001 to December 2004, 617 took 200 milligrams of the NSAID celecoxib twice daily, 596 took 220 milligrams of naproxen sodium twice daily and 904 took placebo. Each year, the study participants took seven tests assessing cognitive function that were added into one global summary score. Treatments were halted in December 2004 because another study found increased cardiovascular risks associated with celecoxib.

“The ADAPT cognitive function results through six months after study treatment cessation do not show a protective effect with the use of NSAIDs and may suggest that cognitive scores are lower,” the authors write. “The global summary scores, which combine the results from seven individual tests in the cognitive assessment battery, were significantly lower over time for naproxen, but not for celecoxib, compared with placebo.”

There are several explanations for the difference between these findings and those of previous observational trials, the authors note. Because observational trials do not assign participants to treatment groups but analyze existing behavior, additional factors that were not measured may have confounded or affected the results. In addition, the findings of this trial may apply only to celecoxib and naproxen and not to other anti-inflammatories, such as ibuprofen. Finally, NSAIDs may be protective only when given several years before the time when cognitive function would have begun to decline.

“Continued follow-up of trial participants, even after cessation of treatment, appears warranted to investigate treatment effects with respect to the timing of exposure,” the authors write. “However, for now we suggest that naproxen and celecoxib should not be used for the prevention of Alzheimer’s disease.”

Source: JAMA and Archives Journals

A new century of Alzheimer's disease research
Imagine the day when a routine visit to the family doctor includes a simple blood test to predict the risk for developing Alzheimer’s disease (AD). If the test returns a worrisome result -- too many sticky brain proteins that might begin to gum up memory and thought in 10 to 15 years -- a person could be offered an aspirin-like pill to keep those proteins in check.
Probing Question: Can Alzheimer's disease be prevented?
Most of us have had the experience of forgetting where we've parked our car or have struggled to recall an acquaintance's name. But once we hit our 50s, said James R. Connor, these incidents might cause us to worry that we're showing early signs of Alzheimer's disease.
Study examines testing model to predict and diagnose new cases of dementia
A preliminary report published in the August 20 issue of JAMA suggests that within-person variability on neuropsychological testing may be associated with development of dementia in older adults.
Do mammals think in 3-D?
A team of neuroscientists at University College London (UCL) has begun to discover how the brain maps three-dimensional space. The work could one day aid in the understanding and treatment of Alzheimer’s disease, which involves the same area of the brain as encodes space.
New criterion may improve identification of dementia risk in highly educated older adults
A different cutoff point on an existing mental function assessment may more effectively assess the risk of dementia in highly educated older adults, according to a report in the July issue of Archives of Neurology.
Seniors with type 2 diabetes may experience memory declines immediately after eating unhealthy meal
Adults with type 2 diabetes who eat unhealthy, high-fat meals may experience memory declines immediately afterward, but this can be offset by taking antioxidant vitamins with the meal, according to new research from Baycrest.
Known Genetic Risk Alzheimer's In Whites Also Places Blacks At Risk
A commonly recognized gene that places one at risk for Alzheimer’s disease does not discriminate between blacks and whites, according to new research led by Florida State University.

Gene variation linked to earlier onset of Alzheimer's symptoms
Investigators at Washington University School of Medicine in St. Louis have identified a genetic variation associated with an earlier age of onset in Alzheimer's disease.

Anti-inflammatory drugs do not improve cognitive function in older adults

Related stories:

News discussion: