By Nancy Deutsch
NEW YORK, Jun 20 (Reuters Health) - It appears that nonsteroidal
anti-inflammatory drugs (NSAIDs)--a class of drug that includes aspirin and
ibuprofen--do enhance brain power in people with Alzheimer's disease, but not in
the way originally thought, Australian researchers report.
Some studies have shown that those who take NSAIDs regularly have a lower
risk of Alzheimer's disease than those who do not. It was originally believed
that this may be due to a reduction in brain inflammation, which appears to
contribute to brain changes seen in people with the memory-robbing disorder.
However, new study findings show that at autopsy, people with Alzheimer's
disease who take long-term NSAIDs have similar signs of inflammation and
deterioration of the brain seen in those who do not take the drugs. This is true
even though the NSAID users did better on memory and psychological tests while
they were alive than those who did not take NSAIDs, according to a report in the
June issue of the Archives of Neurology.
"We were surprised by the results," said lead author Dr. Glenda Halliday of
the Prince of Wales Medical Research Institute in Randwick, Australia.
"Anti-inflammatory medications were thought to work by reducing brain
inflammation and the pathology of Alzheimer's disease."
Halliday noted that NSAIDs might work by a mechanism other than fighting
inflammation. It is possible that the drugs may in some way alter blood supply
to the brain or affect the blood-brain barrier--a layer of cells that helps
protect the brain from substances in the circulation, according to the report.
The study included 12 patients with Alzheimer's, of which 5 were taking high
doses of anti-inflammatory drugs (more than 1,000 milligrams daily of NSAIDs
similar to Naprosyn, a commonly prescribed NSAID), and 10 people without
dementia, of which 3 were taking anti-inflammatory drugs.
When the participants died, autopsies were performed. The Alzheimer's
patients who took NSAIDs had just as many signs of deterioration as the
Alzheimer's patients who had not taken NSAIDs. In some cases, the NSAID users
had greater deterioration.
Replicating this study would be difficult, because following patients for
such a long period of time, testing their brain ability while alive and
examining brain tissue after death, is a long and often difficult research
method. "As the brain is prone to incipient degenerative changes in the elderly,
it will always be difficult to have a large sample of comparison for such a
study," Halliday said.
"NSAIDs do not work via reducing the brain pathology associated with
Alzheimer's disease," she concluded. "They do, however, help reduce cognitive
decline. We now need to find their mechanisms of action and how these mechanisms
contribute to the clinical picture of the disease."
