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. 2018 Mar 28:10:83.
doi: 10.3389/fnagi.2018.00083. eCollection 2018.

NSAID Exposure and Risk of Alzheimer's Disease: An Updated Meta-Analysis From Cohort Studies

Caixia Zhang  1 , Yan Wang  2 , Dongyin Wang  3 , Jidong Zhang  4 , Fangfang Zhang  1
Affiliations

NSAID Exposure and Risk of Alzheimer's Disease: An Updated Meta-Analysis From Cohort Studies

Caixia Zhang et al. Front Aging Neurosci. .

Abstract

Background: Initial observational studies and a systematic review published recently have suggested that non-steroidal anti-inflammatory drug (NSAID) use has the trend to be associated with reduced risk of Alzheimer's disease (AD), while results remain conflicting. Thus, we performed an updated meta-analysis to reevaluate the evidence on this association. Methods: Data sources from PUBMED, Embase and Cochrane Library from inception through April 2017 were searched by two independent reviewers. Eligible cohort studies were selected according to predefined keywords. We did a meta-analysis of available study data using a random-effects model to calculate overall relative risks (RRs) for associations between NSAID exposure and AD risk. Results: From 121 potentially relevant studies, 16 cohort studies including 236,022 participants, published between 1995 and 2016, were included in this systematic review. Meta-analysis demonstrated that current or former NSAID use was significantly associated with reduced risk of AD (RR, 0.81, 95% CI0.70 to 0.94) compared with those who did not use NSAIDs. This association existed in studies including all NSAID types, but not in aspirin (RR, 0.89, 95% CI 0.70 to 1.13), acetaminophen (RR, 0.87, 95% CI 0.40 to 1.91) or non-aspirin NSAID (RR, 0.84, 95% CI 0.58 to 1.23). Conclusions: Current evidence suggests that NSAID exposure might be significantly associated with reduced risk of AD. However, further large-scale prospective studies are needed to reevaluate this association, especially the associations in individual NSAID type.

Keywords: Alzheimer's disease; NSAID; anti-inflammatory drug; aspirin; cohort study.

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Figures

Figure 1
Figure 1
Flow chart of the evidence search and selection process.
Figure 2
Figure 2
Forest plot for association between NSAID exposure and risk of Alzheimer's disease.
Figure 3
Figure 3
Funnel plot for association between NSAID exposure and risk of Alzheimer's disease. RR, relative risk; logrr; the logarithm of relative risk; s.e. of logrr, standard error of logrr.
See this image and copyright information in PMC

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