July 2008

Cognitive function in older adults not improved by anti-inflammatory drugs

A July 2008 article in the Archives of Neurology states that, despite prior observational studies showing an association between use of NSAIDs and lower risk of Alzheimer’s, the anti-inflammatory drugs naproxen and celecoxib do not appear to improve cognitive function in older adults with a family history of Alzheimer’s disease, and naproxen may have a slightly detrimental effect. 

In a National Institute on Aging-supported study, the ADAPT (Alzheimer’s Disease Anti-Inflammatory Prevention Trial) Research Group conducted a randomized clinical trial involving 2,117 individuals age 70 and older with a family history of Alzheimer’s disease. From March 2001 to December 2004, 617 took 200 milligrams of the NSAID celecoxib twice daily, 596 took 220 milligrams of naproxen sodium twice daily and 904 took placebo. Each year, the study participants took seven tests assessing cognitive function that were added into one global summary score. Treatments were halted in December 2004 because another study found increased cardiovascular risks associated with celecoxib.

“The ADAPT cognitive function results through six months after study treatment cessation do not show a protective effect with the use of NSAIDs and may suggest that cognitive scores are lower,” state the authors.  “The global summary scores, which combine the results from seven individual tests in the cognitive assessment battery, were significantly lower over time for naproxen, but not for celecoxib, compared with placebo.” While going on to say that “continued follow-up of trial participants, even after cessation of treatment, appears warranted to investigate treatment effects with respect to the timing of the exposure,” they caution, “for now we suggest that naproxen and celecoxib should not be used for the prevention of Alzheimer’s disease.”