Patterns of anti-inflammatory drug use and risk of dementia: A matched case-control study

A. Dregan*, P. Chowienczyk, D. Armstrong

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Background and purpose: There is limited primary-care-based evidence about a potential association between anti-inflammatory therapy and dementia subtypes. The present study addressed this limitation by using electronic health records from a large primary care database. Method: A case-control study was implemented using electronic medical records. Cases had a diagnosis of dementia between 1992 and 2014. Up to four controls matched on age, gender, family practice and index date were selected for each case. Use of non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoid drugs represented the exposure variables. Primary outcome measures included all-cause dementia and main dementia subtypes, including Alzheimer disease (AD), vascular dementia (VaD) and Lewy body dementia (LBD). Data were analysed using conditional logistic regression. Results: The study identified 31 083 patients with AD, 23 465 with VaD and 1694 with LBD. Ever-used NSAIDs were associated with a modest increase in the risk of all-cause dementia (odds ratio 1.04, 95% confidence interval 1.02-1.05, P < 0.006), whilst no association was apparent for ever-used glucocorticoids (0.98, 0.96-1.01, P = 0.152). There was no evidence for an association between NSAIDs and AD (1.03, 0.99-1.06, P = 0.07) or LBD (1.13, 0.99-1.29, P = 0.08). However, a significant increase in the risk for VaD (1.33, 1.29-1.38, P < 0.001) was observed. Similar patterns emerged for glucocorticoid therapy. Conclusion: In a large primary care population, there was no robust evidence for a potential association between anti-inflammatory drugs and risk of AD or LBD. NSAIDs and glucocorticoid drugs were associated with higher risk of VaD.

Original languageEnglish
Pages (from-to)1421-1428
Number of pages8
JournalEuropean journal of neurology : the official journal of the European Federation of Neurological Societies
Volume22
Issue number11
DOIs
Publication statusPublished - 1 Nov 2015

Keywords

  • Alzheimer disease
  • Case-control
  • Electronic medical records
  • Glucocorticoids
  • Lewy body dementia
  • Non-steroidal anti-inflammatories
  • Vascular dementia

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