Does aspirin protect against Alzheimer's dementia? A study in a Swedish population-based sample aged ≥80 years
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It has been reported that aspirin and other non-steroidal anti-inflammatory drugs (NSAID) may protect against dementia of Alzheimer's type and/or vascular dementia. However, co-morbidity and the dose of aspirin may be critical. A major indication for low-dose aspirin is prophylaxis after stroke and transient ischaemic attacks, conditions that may obscure an anti-dementia effect by the drug. Alternatively, low-dose aspirin may be insufficient if the protective effect is due to an anti-inflammatory mechanism. The aim of this study was to assess whether high-dose or low-dose aspirin may protect against Alzheimer's dementia in subjects aged ≥80 years. For comparison, effects of (other) NSAID, paracetamol and d-propoxyphene were studied.
Global, cross-sectional, and longitudinal (1991–2000) epidemiological analyses of clinical, cognitive and drug treatment data on 702 individuals 80 years old or more (351 twin pairs of same sex), all alive at inclusion: mean age 83.9 years (80–99 years). Calculations were made with logistic regression of associations between use of various analgesics and cognitive function, after adjustment for age, gender, and cardiovascular and cerebrovascular diseases.
Users of high-dose aspirin had significantly lower prevalence of Alzheimer's dementia and better-maintained cognitive function than non-users. There were numerically similar but not significant associations with use of low-dose aspirin and other NSAID. There were no such associations with use of either paracetamol or d-propoxyphene.
Aspirin might protect against Alzheimer's disease, but controlled trials are warranted.
KeywordsAspirin NSAID Alzheimer
The OCTO Twin Study ("The Origins of Variance in the Old-Old: Octogenarian Twins") is an ongoing longitudinal study conducted at the Institute of Gerontology (IG), at the School of Health Sciences in Jönköping, Sweden, in collaboration with the Center for Developmental and Health Genetics at the Pennsylvania State University (PSU), USA, and the Department of Medical Epidemiology at the Karolinska Institute in Stockholm, Sweden. The authors are greatly indebted to the project assistants Lene Ahlbäck, Agneta Carlholt, Gunilla Hjalmarsson, Eva Georgsson and Anna-Lena Wetterholm who travelled throughout the country and examined the twins. Invaluable help in coordinating the study is provided by Inger Cronholm, Ingegerd Brandström at IG, and Elana Pyle at PSU. The authors are also grateful to hospital and health care archivists for their willingness to provide medical records and to Monica Tubbin for her administrative efforts in handling all the records. The study was supported by a grant from the National Institute on Aging (NIA: AG 08861).
- 5.In't Veld BA, Ruitenberg A, Hofman A, Launer LJ, van Duijn CM, Stijnen T, Breteler MMB, Stricker BHC (2001) Nonsteroidal antiinflammatory drugs and the risk of Alzheimer's disease. N Engl J Med 345:1515–1521Google Scholar
- 6.Williams PS, Rands G, Orrel M, Spector A (2000) Aspirin for vascular dementia. Cochrane Database Syst Rev CD001296Google Scholar
- 8.Cederlöf R, Lorich U (1978) (Untitled) in Nance WE, Allen G, Parisi P (eds) Twin research: Part C. Biology and epidemiology. Alan R. Liss, New York, pp 189–195Google Scholar
- 10.WHO Collaborating Centre for Drug Statistics Methodology (1996) Guidelines for ATC classification and DDD assignment. WHO, OsloGoogle Scholar
- 11.American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders DSM-IV, 4th edn. APA, WashingtonGoogle Scholar
- 16.World Health Organization (1992) ICD-10. International statistical classification of diseases and health problems, 10th revised edn., WHO, GenevaGoogle Scholar
- 17.Johansson B, Zarit SH (1995) Prevalence and incidence of dementia in the oldest old: a longitudinal study of a population-based sample of 84–90-year-olds in Sweden. Int J Ger Psychiatry 10:359–366Google Scholar
- 20.American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (DSM-III-R), 3rd edn., APA, WashingtonGoogle Scholar
- 21.Jonsson C-O, Molander L (1964) Manual of the CVB scales. Psykologi Förlaget, StockholmGoogle Scholar
- 22.Dureman I, Sälde H (1959) Psychometric and experimental–psychological methods for clinical application (in Swedish). Almqvist & Wiksell, UppsalaGoogle Scholar
- 23.Wechsler D (1991) Manual for the Wechsler adult intelligence-scale revised. Psychological Corporation, New YorkGoogle Scholar
- 24.Thurstone LL, Thurstone TG (1949) Manual to SRA primary mental abilities. Science Research Associates, ChicagoGoogle Scholar
- 25.Johansson B (1988) The MIR—memory in reality test. Psykologiförlaget AB, StockholmGoogle Scholar
- 26.Johansson B, Zarit SH (1991) Dementia and cognitive impairment in the oldest-old: a comparison of two rating methods. Int Psychogeriatr Spring 12:29–38Google Scholar