NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND DYSPEPSIA IN THE ELDERLY

Upper gastrointestinal tract symptoms are common in the elderly and, d espite a paucity of data, nonsteroidal antiinflammatory drugs (NSAIDs) are believed to be important risk factors. We aimed to evaluate the a ssociation of NSAIDs with dyspepsia and heartburn in a population-base d study. An age- and gender-stratified random sample of Olmsted County , Minnesota, Caucasian residents aged 65 years and older was mailed a valid self-report questionnaire; 74% responded (N = 1375). Age- and ge nder-adjusted (to 1980 US Caucasian population) prevalence rates for N SAID use, dyspepsia (defined as pain located in the upper abdomen or n ausea), and heartburn (defined as retrosternal burning pain) were calc ulated. Logistic regression analysis was used to estimate the associat ion of dyspepsia and heartburn with potential risk factors adjusting f or age and gender. The age- and gender-adjusted annual prevalences (pe r 100) of aspirin and nonaspirin NSAID use were 60.0 (95% CI 57.2,62.7 ) and 26.1 (95% CI 23.6,28.7), respectively. The annual prevalences of dyspepsia and heartburn were 15.0 (95% CI 12.9,17.0) and 12.9 (95% CI 10.9,14.8), respectively. Aspirin was associated with dyspepsia and/o r heartburn (OR = 1.6, 95% CI 1.2,2.2) as were nonaspirin NSAIDs (OR = 1.8, 95% CI 1.3,2.6), but smoking and alcohol were not significant ri sk factors. Aspirin and nonaspirin NSAIDs are associated with almost a twofold risk of upper gastrointestinal tract symptoms in elderly comm unity subjects.