Nilsson Sven E, Johansson Boo, Takkinen Sanna, Berg Stig, Zarit Steven, McClearn Gerald, Melander Arne
Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden.
Eur J Clin Pharmacol. 2003 Aug;59(4):313-9. doi: 10.1007/s00228-003-0618-y. Epub 2003 Jun 25.
It has been reported that aspirin and other non-steroidal anti-inflammatory drugs (NSAID) may protect against dementia of Alzheimer's type and/or vascular dementia. However, co-morbidity and the dose of aspirin may be critical. A major indication for low-dose aspirin is prophylaxis after stroke and transient ischaemic attacks, conditions that may obscure an anti-dementia effect by the drug. Alternatively, low-dose aspirin may be insufficient if the protective effect is due to an anti-inflammatory mechanism. The aim of this study was to assess whether high-dose or low-dose aspirin may protect against Alzheimer's dementia in subjects aged > or =80 years. For comparison, effects of (other) NSAID, paracetamol and D-propoxyphene were studied.
Global, cross-sectional, and longitudinal (1991-2000) epidemiological analyses of clinical, cognitive and drug treatment data on 702 individuals 80 years old or more (351 twin pairs of same sex), all alive at inclusion: mean age 83.9 years (80-99 years). Calculations were made with logistic regression of associations between use of various analgesics and cognitive function, after adjustment for age, gender, and cardiovascular and cerebrovascular diseases.
Users of high-dose aspirin had significantly lower prevalence of Alzheimer's dementia and better-maintained cognitive function than non-users. There were numerically similar but not significant associations with use of low-dose aspirin and other NSAID. There were no such associations with use of either paracetamol or D-propoxyphene.
Aspirin might protect against Alzheimer's disease, but controlled trials are warranted.
据报道，阿司匹林和其他非甾体抗炎药（NSAID）可能预防阿尔茨海默病型痴呆和/或血管性痴呆。然而，合并症和阿司匹林剂量可能至关重要。低剂量阿司匹林的一个主要适应证是中风和短暂性脑缺血发作后的预防，而这些情况可能会掩盖该药物的抗痴呆作用。另外，如果保护作用是由于抗炎机制，低剂量阿司匹林可能并不足够。本研究的目的是评估高剂量或低剂量阿司匹林是否可预防80岁及以上老年人患阿尔茨海默病性痴呆。为作比较，还研究了（其他）NSAID、对乙酰氨基酚和右丙氧芬的作用。
对702名80岁及以上（351对同性双胞胎）个体的临床、认知和药物治疗数据进行全面、横断面和纵向（1991 - 2000年）流行病学分析，所有纳入者均存活：平均年龄83.9岁（80 - 99岁）。在对年龄、性别以及心血管和脑血管疾病进行校正后，采用逻辑回归分析各种镇痛药的使用与认知功能之间的关联。
高剂量阿司匹林使用者患阿尔茨海默病性痴呆的患病率显著低于非使用者，且认知功能维持得更好。低剂量阿司匹林和其他NSAID的使用与认知功能之间存在数值上相似但不显著的关联。对乙酰氨基酚或右丙氧芬的使用与认知功能无此类关联。
阿司匹林可能预防阿尔茨海默病，但仍需进行对照试验。
