Can NSAID Use Lower the Risk of Cognitive Decline?

The use of non-steroidal anti-inflammatory drugs (NSAIDs) may be linked to a reduced risk of cognitive decline, according to a meta-analysis published in Drugs & Aging. 

Among the elderly population, NSAIDs are one of the most commonly used medications. This drug class has been evaluated for possible prevention against cognitive decline due to its anti-inflammatory properties, which maintains cerebral blood circulation and diminishes the neurotoxicity of microglial cells.  

“However, results from some prospective observational studies identifying the association between NSAID use and cognitive decline risk remain inconclusive,” noted study author DongFeng Zhang, from The Medical College of Qingdao University, Qingdao, China. 

Zhang and colleagues conducted a meta-analysis of prospective studies to assess the impact of NSAID use on the risk of cognitive decline. They identified 2,171 articles through the PubMed, EMBASE, and China National Knowledge Infrastructure databases to December 2015. Sensitivity analyses were performed to examine the robustness of the data and the small-study effect was evaluated using Egger’s test and funnel plots. 

A total of 10 articles, including 11 prospective cohort studies, were included in the analysis. Study authors found that NSAID use was associated with a 13% reduced risk of cognitive decline (pooled risk ratio [RR] 0.87, 95% CI: 0.81-0.94). A subgroup analysis showed the pooled RRs were 0.89 (95% CI: 0.78-0.93) for ≥5 years follow-up, 0.85 (95% CI: 0.75-0.96) for <5 years follow-up, and 0.85 (95% CI: 0.78-0.93) for studies conducted in North America, respectively. Study results were found to be robust and there was no evidence of significant small-study effect, the team reported.

Overall, the meta-analysis indicates that the use of NSAIDs may be tied to a lower risk of cognitive decline. However, larger, high-quality randomized controlled trials are warranted to confirm the effects of NSAID use on the risk of cognitive decline. 

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