Ibuprofen Use Cuts Alzheimer’s Risk, Study Says

The risk of developing Alzheimer’s disease can be reduced by as much as 60% by frequent consumption of the common anti-inflammatory drug ibuprofen over two years or longer, a massive study to be released today has shown.

Even shorter use could reduce the risk by as much as 35%, a team from Johns Hopkins University and the National Institute on Aging reports in the journal Neurology.

Earlier studies had hinted that ibuprofen, commonly known as Advil, Motrin or Nuprin, and other anti-inflammatory drugs might delay the onset of Alzheimer’s, but this is the largest study to date and perhaps the most convincing, experts said.

The researchers noted no similar benefit for aspirin, which is an even more powerful anti-inflammatory agent than ibuprofen. But they cautioned that the study participants may not have taken large enough doses of aspirin to be effective.

Acetaminophen (known as Tylenol), another painkiller that has no anti-inflammatory properties, also had no protective effect.

But the researchers cautioned against widespread use of ibuprofen in an effort to stave off the debilitating disease, which affects as many as 4 million Americans, most of them over 65. The drug can cause peptic ulcers and kidney damage.

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“Using [ibuprofen] seems to offer promise as a way to prevent or delay the onset of Alzheimer’s, but we will need clinical trials to prove that [it] confers protection and, ultimately, to make public health recommendations to reduce risk,” said epidemiologist Walter F. Stewart of the Johns Hopkins School of Public Health.

“Ibuprofen can shut down your kidneys,” added Dr. Claudia Kawas of the Johns Hopkins School of Medicine. “That would be a terrible thing to do while trying to prevent something you might not even get.”

But they said that people who are already taking the drugs routinely for other purposes may enjoy an anti-Alzheimer’s effect as a bonus.

Alzheimer’s is characterized by memory loss, disorientation, depression and deterioration of bodily functions. It is ultimately fatal, causing about 100,000 deaths in the United States each year.

Researchers have long viewed anti-inflammatory agents as a potential treatment for Alzheimer’s because it is known that at least part of the damage to the brain from the disease is caused by the accumulation of white blood cells triggered by the immune system. If this inflammatory process could be blocked, they reasoned, the onset of the disease might be delayed.

In fact, some studies have shown that very powerful anti-inflammatory agents, such as indomethacin, can slow disease progression. Unfortunately, such drugs have side effects that may often be worse than Alzheimer’s itself.

Researchers are also conducting promising clinical trials with a milder anti-inflammatory agent called prednisone, as well as with aspirin, ibuprofen and other anti-inflammatories, such as naproxyn, to see if they will slow the progression of symptoms once Alzheimer’s has been diagnosed.

The current study, however, focused on routine use of the drugs long before symptoms became apparent.

The study centered on a group of about 2,300 people, most of whom have been studied since 1958 as part of the Baltimore Longitudinal Study of Aging, conducted at Hopkins and sponsored by the aging institute. Since 1978, the research team has asked participants about their use of non-steroidal anti-inflammatory drugs, commonly called NSAIDs.

Volunteers in the continuing study range in age from 20 to 97, although most are now in the older age brackets. Researchers were not able to determine whether the benefits of ibuprofen varied with age.

Stewart, Kawas and their colleagues found that the average risk of developing Alzheimer’s among all the 1,686 participants who regularly took the drugs was about half the risk among those who did not. The longer the subjects took them, the lower the risk of Alzheimer’s. The risk was about 35% lower in patients who had been taking the drugs for less than two years, but a full 60% lower among those who had been taking them for more than two years.

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Kawas noted that some were taking the drugs once or twice a week, while others were consuming them once or twice a day. “What would be the best dosage and frequency is completely unknown” for now, she said.

The team also looked at the effects of estrogen and, as is the case with other recently reported studies, found that it also provided a protective effect. They did not have enough data, however, to determine if estrogen and the anti-inflammatory drugs together offered greater protection than either drug alone.

Kawas--whose family history makes her think she will develop Alzheimer’s--does not take such drugs prophylactically herself. “I’m not saying others shouldn’t do it, but for myself, I think the information has not yet developed enough to do it.”

But within the next decade, she added, “I believe we will be able to give advice that will delay the onset of Alzheimer’s by substantial amounts, by years.”