NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND COGNITIVE DECLINE IN THE ELDERLY

Objective. To better define the role of nonsteroidal antiinflammatory drugs (NSAID) in cognitive decline of the elderly. Methods. Population based inception cohort of the rural elderly, NSAID user status was ch aracterized as high dose, low/medium dose, or nonuser at 2 successive in-person interviews 3 years apart (F3 and F6). Respondents were from the Iowa 65+ Rural Health Study, one of the 4 cohorts of the National Institute on Aging's Established Populations for Epidemiologic Studies of the Elderly, Memory decline was assessed by a change in immediate word recall between F3 and F6. Multivariable logistic regession models were created to determine important predictors of the F3 to F6 recall memory decline in groups with poor, average, and good word recall at the F3 interview. Specific NSAID were compared to assess which drugs, if any, were associated with memory decline. Results. The 2 factors mo st strongly associated with a significant immediate word recall declin e between F3 and F6 among individuals in the average F3 word recall gr oup were limitation in functional status [odds ratio (OR) = 2.31, 95% Confidence Interval (CI) (1.51, 3.52)] and high dose NSAID use [OR = 2 .04, 95% CI (1.07, 3.89)]. No single NSAID agent was significantly mor e strongly associated with word recall decline than the others. Howeve r, in exploratory analyses use of high dose NSAID of the proprionic ac id family neared significance for recall decline [OR = 3.17, 95% CI (0 .92, 10.9)]. Conclusion. In elderly respondents with average baseline recall memory, high dose NSAID were a significant risk factor for long itudinal memory decline in this community based cohort. Although a lar ge scale clinical trial is needed to definitively address this issue, we provide further evidence that NSAID play a role in cognitive dysfun ction in the elderly.