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From the Department of Epidemiology (Dr. Stewart), Johns Hopkins School of Public Health; Department of Neurology (Dr. Kawas and M. Corrada), Johns Hopkins School of Medicine; and Gerontology Research Center/National Institute on Aging (Drs. Kawas and Metter), Baltimore, MD.
Supported in part by a grant from the National Institute on Aging (NIA) (R01AG08325).
Received May 15, 1996. Accepted in final form August 30, 1996.
Address correspondence and reprint requests to Dr. Walter F. Stewart, Department of Epidemiology, School of Hygiene and Public Health, 615 N. Wolfe Street, Baltimore, MD 21205.
Article abstract-In a longitudinal study of 1,686 participants in the Baltimore Longitudinal Study of Aging, we examined whether the risk of Alzheimer's disease (AD) was reduced among reported users of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). In addition, we examined use of acetaminophen, a pain-relief medication with little or no anti-inflammatory activity, to assess the specificity of the association between AD risk and self-reported medications. Information on use of medications was collected during each biennial examination between 1980 and 1995. The relative risk (RR) for AD decreased with increasing duration of NSAID use. Among those with 2 or more years of reported NSAID use, the RR was 0.40 (95% confidence interval [CI]: 0.19-0.84) compared with 0.65 (95% CI: 0.33-1.29) for those with less than 2 years of NSAID use. The overall RR for AD among aspirin users was 0.74 (95% CI: 0.46-1.18), and no trend of decreasing risk of AD was observed with increasing duration of aspirin use. No association was found between AD risk and use of acetaminophen (RR = 1.35; 95% CI: 0.79-2.30), and there was no trend of decreasing risk with increasing duration of use. These findings are consistent with evidence from cross-sectional studies indicating protection against AD risk among NSAID users and with evidence suggesting that one stage of the pathophysiology leading to AD is characterized by an inflammatory process.
NEUROLOGY 1997;48: 626-632
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