Journal Article

Meta-Analysis of Nonsteroidal Antiinflammatory Drug Use and Risk of Dementia

Anton J. M. de Craen, Jacobijn Gussekloo, Bram Vrijsen and Rudi G. J. Westendorp

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 161, issue 2, pages 114-120
Published in print January 2005 | ISSN: 0002-9262
Published online January 2005 | e-ISSN: 1476-6256 | DOI: https://dx.doi.org/10.1093/aje/kwi029
Meta-Analysis of Nonsteroidal Antiinflammatory Drug Use and Risk of Dementia

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The authors performed a systematic review to summarize the epidemiologic evidence on the association between use of nonsteroidal antiinflammatory drugs (NSAIDs) and the risk of dementia. A total of 25 case-control and cohort studies that reported an odds ratio/relative risk were included. Study-specific log relative risks were weighted by the inverse of their variances to obtain pooled relative risks and 95% confidence intervals. The authors divided the reports into studies with prevalent dementia cases, studies with incident dementia cases, and studies where cognitive decline was used as the clinical endpoint. The pooled relative risks of the three groups of studies were 0.51 (95% confidence interval (CI): 0.37, 0.70), 0.79 (95% CI: 0.68, 0.92), and 1.23 (95% CI: 0.70, 2.31), respectively. Within these subgroups, heterogeneity was present only in the studies with prevalent cases (p = 0.001). Because the benefit of NSAIDs in preventing dementia or cognitive impairment was 50% in studies with prevalent dementia cases, declined to 20% in studies with incident dementia cases, and was absent in studies where cognitive decline was used as the endpoint, the authors conclude that most of the reported beneficial effects of NSAIDs may result from various forms of bias: recall bias, prescription bias, and publication bias.

Keywords: Alzheimer disease; anti-inflammatory agents, non-steroidal; dementia; meta-analysis; CI, confidence interval; NSAID(s), nonsteroidal antiinflammatory drug(s).

Journal Article.  5128 words.  Illustrated.

Subjects: Public Health and Epidemiology

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