Diclofenac May Slow Cognitive Decline in Alzheimer Disease

Study results showed that most common NSAIDs, including aspirin, ibuprofen, naproxen, and celecoxib did not alter cognitive degeneration in patients with mild cognitive impairment or Alzheimer disease
Study results showed that most common NSAIDs, including aspirin, ibuprofen, naproxen, and celecoxib did not alter cognitive degeneration in patients with mild cognitive impairment or Alzheimer disease

The following article is part of conference coverage from the 2018 Alzheimer's Association International Conference in Chicago, Illinois. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAIC 2018.

CHICAGO — While most common nonsteroidal anti-inflammatory drugs (NSAIDs) do not significantly affect cognitive decline in patients with Alzheimer disease or mild cognitive impairment, research presented at the 2018 Alzheimer's Association International Conference, held July 22-26, 2018, in Chicago, Illinois suggests that diclofenac actually reduces cognitive deterioration, while acetaminophen accelerates decline.

The study investigated cognitive decline associated with NSAID use in 1619 patients from the Alzheimer's Disease Neuroimaging Initiative dataset. The Mini-Mental State Examination and the Alzheimer disease assessment scale were used to evaluate cognitive functioning. Additional variables that potentially explain cognitive decline were identified for the cohort including gender, apolipoprotein E genotype, level of education, vascular disorders, diabetes, and medication use.

Study results showed that most common NSAIDs, including aspirin, ibuprofen, naproxen, and celecoxib did not alter cognitive degeneration in patients with mild cognitive impairment or Alzheimer disease. Diclofenac was the only NSAID that demonstrated a correlation with a slower rate of cognitive decline (ADAS χ2=4.0, P =.0455, MMSE χ2=4.8, P =.029). Conversely, acetaminophen was correlated with accelerated cognitive deterioration (ADAS χ2=6.6, P =.010, MMSE χ2=8.4, P =.004), as well as apolipoprotein E ε4 genotype (ADAS χ2=316.0, P <.0001, MMSE χ2=191.0, P <.0001).

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Diclofenac's correlation with slowed cognitive deterioration provides “exciting evidence for a potential disease modifying therapeutic,” the study authors wrote. If acetaminophen's deleterious effects are confirmed to be causative, it “would have massive ramifications for the recommended use of this prolific drug.”

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Reference

Rivers-Auty J, Mather AE, Peters R, Lawrence CB, Brough D. Use of common pain relieving drugs correlate with altered progression of Alzheimer's disease and mild cognitive impairment. Presented at: 2018 Alzheimer's Association International Conference. July 22-26, 2018; Chicago, IL. Abstract 23340.