Can Arthritis Drugs Prevent Alzheimers?

Nov. 21, 2001 -- Millions of people regularly take anti-inflammatory drugs to relieve the pain of arthritis. New research now offers some of the strongest evidence yet that they are also protecting themselves against Alzheimer's disease.

Researchers from Rotterdam's Erasmus Medical Center followed nearly 7,000 older people for seven years. They found that those taking anti-inflammatory drugs like Motrin, Advil or Aleve for at least two years to reduce pain and inflammation were significantly less likely to develop Alzheimer's than those who rarely or never took the drugs.

The findings are reported in the Nov. 22 issue of TheNew England Journal of Medicine.

But this does not mean that people should start taking these potentially life-threatening drugs, researchers say. Stomach and intestinal bleeding due to anti-inflammatory use are more likely to occur in older people and can lead to serious illness and even death.

"I would be very unhappy if this research resulted in people using these drugs improperly," study author Bruno Stricker, PhD, tells KB120. "This could be quite dangerous, especially in the elderly, because the risk of [bleeding] is quite substantial."

Stricker and colleagues reported that dementia developed in just under 400 of the almost 7,000 people they followed during the eight-year study. All participants were 55 or older and had no signs of dementia at the beginning of the study.

The dose of anti-inflammatory did not seem to be important. However, the drugs were protective only when taken for at least two years prior to developing dementia symptoms.

Alzheimer's researcher Peter P. Zandi, PhD, says this could explain why most previous studies found that anti-inflammatories didn't protect against the disease. In an editorial, Zandi and colleague John Breitner of Baltimore's Johns Hopkins University, noted that earlier studies just looked at people who had already developed symptoms of Alzheimer's.

"It is growing more and more evident that timing is critical with regard to these drugs," Zandi tells KB120. "Anti-inflammatories do not appear to have a protective effect unless they are used more than two years prior to developing Alzheimer's symptoms."

It has been widely believed that anti-inflammatories need to be taken at doses used for arthritis to protect against Alzheimer's disease. But several newly published studies, including one by Zandi's team, suggest this is not the case.

The researchers found that long-term, low-dose aspirin (81 mg) -- also an anti-inflammatory drug -- appears to protect against the brain disease in older people. The current study group did not look at aspirin's effects on Alzheimer's.

If the findings are confirmed, it means that millions of people who are already on low-dose aspirin to protect their hearts are also protecting themselves against Alzheimer's.

Zandi says a new group of anti-inflammatories with fewer intestinal side effects may also prove to be protective against the disease. Known as COX-2 inhibitors, the drugs Vioxx and Celebrex are just beginning to be studied by Alzheimer's researchers.

The Johns Hopkins team has begun a study of anti-inflammatory drug use among people with a family history of Alzheimer's disease, and will include the COX-2 inhibitors in that study, Zandi says. The participants will take either anti-inflammatory drugs regularly or not at all, and they will be followed for five years.

"The evidence is accumulating that anti-inflammatory drugs do decrease the risk of Alzheimer's, but we still don't have the proof," Zandi says.