Saag K G, Rubenstein L M, Chrischilles E A, Wallace R B
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242, USA.
J Rheumatol. 1995 Nov;22(11):2142-7.
To better define the role of nonsteroidal antiinflammatory drugs (NSAID) in cognitive decline of the elderly.
Population based inception cohort of the rural elderly. NSAID user status was characterized 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 regression 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.
The 2 factors most strongly associated with a significant immediate word recall decline between F3 and F6 among individuals in the average F3 word recall group 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 more strongly associated with word recall decline than the others. However, in exploratory analyses use of high dose NSAID of the proprionic acid family neared significance for recall decline [OR = 3.17, 95% CI (0.92, 10.9).
In elderly respondents with average baseline recall memory, high dose NSAID were a significant risk factor for longitudinal memory decline in this community based cohort. Although a large scale clinical trial is needed to definitely address this issue, we provide further evidence that NSAID play a role in cognitive dysfunction in the elderly.
更好地明确非甾体抗炎药（NSAID）在老年人认知功能衰退中的作用。
以农村老年人为基础的起始队列研究。通过相隔3年的两次面对面访谈（F3和F6）将NSAID使用者状态分为高剂量、低/中剂量或非使用者。研究对象来自爱荷华65岁以上农村健康研究，该研究是美国国立衰老研究所老年人流行病学研究既定人群的4个队列之一。通过比较F3和F6之间即时单词回忆的变化来评估记忆衰退情况。建立多变量逻辑回归模型以确定在F3访谈中单词回忆能力差、中等和良好的组中F3至F6回忆记忆衰退的重要预测因素。比较特定的NSAID以评估哪些药物（如果有）与记忆衰退相关。
在F3单词回忆能力中等的组中，与F3和F6之间即时单词回忆显著下降最密切相关的两个因素是功能状态受限[比值比（OR）=2.31，95%置信区间（CI）（1.51，3.52）]和高剂量NSAID使用[OR =2.04，95% CI（1.07，3.89）]。没有单一的NSAID药物比其他药物与单词回忆下降的关联更显著。然而，在探索性分析中，使用高剂量丙酸类NSAID与回忆下降接近显著相关[OR =3.17，95% CI（0.92，10.9）]。
在基线回忆记忆中等的老年研究对象中，高剂量NSAID是这个基于社区的队列中纵向记忆衰退的一个重要危险因素。尽管需要大规模临床试验来明确解决这个问题，但我们提供了进一步的证据表明NSAID在老年人认知功能障碍中起作用。
