This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Nonsteroidal anti-inflammatory drugs (NSAIDs) have long been hypothesized to play a protective role in Alzheimer disease (AD). This hypothesis is supported by a large number of cohort studies; a recent meta-analysis of 16 studies demonstrated that current or former NSAID use was associated with a reduced relative risk (RR) of AD (RR 0.81; 95% confidence interval 0.70–0.94).1 A role for NSAIDs in AD is consistent with the increasing evidence that inflammatory activity plays a crucial role in AD pathogenesis.2,3 In AD, protein complexes of β-amyloid and hyperphosporylated tau interact with microglia and astrocytes and result in the secretion of cytokines and chemokines, markers of inflammatory activation. Despite the observational epidemiologic data on the protective effect of NSAIDs and the evidence for a biologically plausible role of anti-inflammatory treatment, a large multiyear randomized placebo-controlled trial with naproxen and celecoxib (Alzheimer's Disease Anti-inflammatory Prevention Trial [ADAPT]) failed to support the hypothesis that either drug could delay the onset of AD in adults with a family history of dementia.4 While these initial results were disappointing, there was a suggestion of an effect among 3 of the cognitive subtests in the naproxen arm of this study,5 which led the investigators to design a subsequent naproxen trial, using a more sensitive outcome measure.
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
See page 835
- © 2019 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hastening the Diagnosis of Amyotrophic Lateral Sclerosis
Dr. Brian Callaghan and Dr. Kellen Quigg