San Francisco
REGULAR doses of simple painkillers may dramatically reduce the risk of
developing Alzheimer鈥檚 disease. The finding, announced at a meeting of the
American Academy of Neurology in San Francisco last week, supports the theory
that Alzheimer鈥檚 may result from an inflammation of the brain.
The work was part of the Baltimore Longitudinal Study on Aging, which has
followed the healthcare habits of almost 2000 people living in Baltimore since
the 1960s. Since 1989, neurologist Claudia Kawas and epidemiologist Walter
Stewart at the Johns Hopkins School of Medicine in Baltimore have examined 1686
of these people and found that 84 of them suffered from Alzheimer鈥檚 disease.
From the study鈥檚 database, they built up a picture of the drugs and medication
each patient had taken over the previous 14 years.
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They found a striking correlation. Patients who identified themselves as
鈥渕ore than occasional鈥� users of pain-relieving nonsteroidal
anti-inflammatory drugs (NSAIDs) were half as likely to develop Alzheimer鈥檚 as
non-users. The longer they had been taking the drugs, the lower their risk of
Alzheimer鈥檚. 鈥淭his raises exciting prevention opportunities,鈥� says Stewart. The
effect seems to be specific to NSAIDs such as ibuprofen, naprosyn and
indomethacin. Acetominophen, which relieves pain but has no effect on
inflammation, did not prevent the disease. Aspirin seemed to have an
insignificant effect.
The idea that treating inflammation could stop the advance of Alzheimer鈥檚
disease was first suggested in 1993 by Joe Rogers of the Sun Health Research
Institute in Sun City, Arizona and Pat McGeer of the University of British
Columbia in Vancouver. They discovered that certain immune cells run rampant
around the brain lesions that characterise Alzheimer鈥檚 disease鈥攁 process
which anti-inflammatory drugs should stop.
This was borne out when McGeer and Rogers examined old hospital records and
discovered a dip in the incidence of Alzheimer鈥檚 among patients who regularly
took NSAIDs, for arthritis, for example. But the new study provides the first
insights into how the history of drug use can can alter the risk of disease.
鈥淭his new result throws the effect into much sharper focus than ever before,鈥�
says McGeer.
However, chronic use of such drugs carries the risk of stomach irritation and
even gastric bleeding. 鈥淭hey are really designed to be used for weeks, not
years,鈥� says Stewart. In a small trial of indomethacin, more than a third of 22
Alzheimer鈥檚 patients given the drug had to stop because they suffered
gastrointestinal problems.
So while the researchers are not recommending that everyone should start
popping painkillers, they hope to begin larger trials to determine who might
benefit the most, and how much of the drugs they might need. 鈥淚t鈥檚 clear there
will be a tradeoff between these risks,鈥� says Stewart. 鈥淏ut the time to set up
clinical trials to resolve these key issues is now.鈥�