Ibuprofen, Naproxen and other NSAIDs for Alzheimer’s

Large observational studies have linked regular use of painkillers such as ibuprofen (Advil) and naproxen (Aleve) with lowered risk of Alzheimer’s, but clinical trials have not backed this up. The publication of the results of two new studies this month didn’t do much to resolve this issue. In the first study, Boston University researchers analyzed the medical records of hundreds of thousands of military veterans, and found long-term use of NSAIDs (non-steroidal anti-inflammatory drugs), particularly ibuprofen, was associated with a reduced risk of Alzheimer’s.

A detailed analysis of the results of the second study, ADAPT (Alzheimer's Disease Anti-inflammatory Prevention Trial), was published this month. It showed that neither naproxen nor another NSAID, celecoxib, improved thinking and memory in more than 2000 men and women 70 years and older who had a family history of Alzheimer’s. Naproxen actually seemed to worsen cognition. The trial was stopped early because scientists worried about the side effects of the two painkillers.

Differences in study design could explain these conflicting results.

Constantine Lyketsos, MD, MPH

The various studies tested different NSAIDs at different dosages in different populations for different lengths of time. It’s also possible that there were “confounding factors” in the population studies – maybe people who take NSAIDs had later onset of Alzheimer’s because they had higher education levels or better overall health, for example.

So, what DO we know about NSAIDs and memory loss? “After the onset of dementia, anti-inflammatory treatment does not seem to work,” says Dr. Constantine Lyketsos, one of the researchers involved in ADAPT. “The data are pretty strong.” Dr. Lyketsos is Director of the Memory and Alzheimer’s Treatment Center at Johns Hopkins University and Chairman of the Department of Psychiatry at Johns Hopkins Bayview Medical Center. 

If treatment with NSAIDs does not seem to be effective, what about prevention?

"At present, there is only one randomized trial and that is ADAPT, in which treatment had to be stopped early,” says Dr. Lyketsos. “It does not support the idea that within a few years of dementia onset, the NSAIDs used prevent Alzheimer’s disease. As the observational studies suggest, other NSAIDs might, or the same ones might if given for longer and or earlier in life.”

“Still, right now people are not advised to use NSAIDs to treat or prevent Alzheimer’s disease or memory disorders,” he says. “These drugs carry risks, and as we found in ADAPT, some may have the possibility of being harmful to cognition.”

Another NSAID, Flurizan, is in trial for treatment of Alzheimer’s. Research is focused on its ability to lower levels of beta amyloid (the protein thought to cause Alzheimer’s), rather than on any anti-inflammatory properties. Results are due out this summer.

Comments

[Roxales]

I was curious about ibuprofen and memory loss, I am a 42 yrs old female, since I was a child I would consider myself as having pretty good memory, as a business owner I would say I could addressed a bunch of our customers by first and last name, but progressively I realized I wasn't able to do it anymore, or when having conversations I could not remember peoples names, places names I have visited before, or specific names that I was referring to in a conversation. It was pretty scary, I was trying to figure out why this was happening, finally my conclusion was maybe "the blessed advil that I take for any pain" is causing it (take in consideration that I have never been prescribed with any kind of medication). I used to carry a bottle of advil in my purse, take it whenever I had a slight headache, or pms cramps, or muscle pain after jogging, etc. Finally I have stop taking it and seems that my memory is slowly improving.