Drugs & Aging

, Volume 33, Issue 7, pp 501–509 | Cite as

Association Between Non-Steroidal Anti-Inflammatory Drug Use and Cognitive Decline: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Systematic Review
First Online:

Abstract

Background

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used medications in the elderly. They have been widely studied as possible preventive agents against cognitive decline because of the properties of anti-inflammatories, which sustain cerebral blood flow and mitigate the neurotoxicity of microglial cells. However, the results remain controversial.

Objective

Our objective was to assess the effects of NSAID use on the risk of cognitive decline. We reviewed and quantitatively synthesized the evidence from prospective cohort studies via a meta-analysis.

Methods

We identified pertinent studies by searching the PubMed, EMBASE, and China National Knowledge Infrastructure databases through to December 2015 and by reviewing the reference lists of retrieved articles. We used fixed- or random-effects models to pool relative risks (RRs) with 95 % confidence intervals (CIs) and performed sensitivity analyses to evaluate the robustness of the results. Small-study effect was evaluated using Egger’s test and funnel plots.

Results

Of the 2171 articles identified through searching the databases, ten articles including 11 prospective cohort studies were eligible. Overall, NSAID use was associated with a 13 % decreased risk of cognitive decline (pooled RR 0.87; 95 % CI 0.81–0.94). In subgroup analysis, the pooled RRs were 0.89 (95 % CI 0.81–0.98) for follow-up time ≥5 years, 0.85 (95 % CI 0.75–0.96) for follow-up time <5 years, and 0.85 (95 % CI 0.78–0.93) for studies conducted in North America, respectively. Sensitivity analyses found results to be robust. No evidence of significant small-study effect was identified.

Conclusions

This meta-analysis of prospective cohort studies indicates that NSAID use may be associated with a decreased risk of cognitive decline. Larger, high-quality randomized controlled trials are needed to verify the effects of NSAID use on the risk of cognitive decline.

Keywords

Cerebral Blood Flow Cognitive Decline Prospective Cohort Study Rofecoxib China National Knowledge Infrastructure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Compliance with Ethical Standards

Source of funding

This work was supported by the National Natural Science Foundation of China (No. 31371024).

Conflict of interest

WeiJing Wang, YanPing Sun, and DongFeng Zhang declare that they have no conflicts of interest relevant to the content of this article.

Supplementary material

40266_2016_379_MOESM1_ESM.pdf (170 kb)
Supplementary material 1 (PDF 169 kb)

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Epidemiology and Health StatisticsThe Medical College of Qingdao UniversityQingdaoPeople’s Republic of China
  2. 2.Department of NeurologyThe Affiliated Hospital of Qingdao UniversityQingdaoPeople’s Republic of China

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