nixing Alzheimer's

From: Damien Broderick (
Date: Thu Nov 22 2001 - 18:21:18 MST


I very briefly reviewed a book some years ago that made the following claim:

Forever Young: Science and the Search for Immortality By Jim Schnabel,
Bloomsbury, 229pp

< Still, is there a deep plan for the course of human life, one that dooms
us inevitably to death? Brilliant and cool, as funny in his sardonic way as
P. J. O'Rourke, journalist Jim Schnabel roamed America in his baby blue
Cadillac in search of scientific answers to mortality. His choice of
laboratories and experts is inspired, his tale sublimely apt at the
millennium's turn. Is Alzheimer's disease, for instance, a curable kind of
arthritic inflammation? Yes, says Schnabel, and the drugs to stop it are in
clinical trials right now, perhaps on sale by 2004. >


November 22, 2001

Hints of an Alzheimer's Aid in Anti-Inflammatory Drugs


 Middle-age and elderly people who took anti-inflammatory drugs like
ibuprofen or naproxen for at least two years were apparently protected from
Alzheimer's disease, according to a new study by scientists in the
Netherlands. Their likelihood of getting Alzheimer's dementia was one-
sixth that of people who did not take the drugs.

The study, published today in The New England Journal of Medicine, offers
hope for preventing Alzheimer's but falls short of being definitive,
experts said. They cautioned that the findings did not mean that people
should dose themselves with anti- inflammatories, which can have serious
side effects, to prevent Alzheimer's.

The researchers, led by Dr. Bruno H. C. Stricker of the Erasmus Medical
Center in Rotterdam, invited every person 55 or older in a suburb of
Rotterdam, Ommoord, to participate in their study. Of 10,275 who were
asked, 6,989 agreed and were eligible. None had Alzheimer's. But by the end
of the study, 293 had developed it.

Some participants took anti-inflammatories and some did not, by their own
choice and not the researchers' design. Most who took the drugs used them
for arthritis.

In the group that took no anti- inflammatory drugs, 210 out of 2,553
developed dementia. But 3 out of 233 who had taken the drugs for at least
two years developed it. The dose did not appear to be important, the
researchers found.

The effect was specific for Alzheimer's. The drugs did not help other
diseases like ministrokes, which can cause memory loss and confusion.

The sole drugs that seemed to affect the risk of Alzheimer's were
anti-inflammatories. Aspirin, unlike other anti-inflammatory drugs, did not
appear to have a protective effect, possibly, the researchers said, because
participants were taking very low doses.

Dr. John Breitner, an Alzheimer's disease researcher at the Johns Hopkins
Bloomberg School of Public Health, said the new study was impressive.
Unlike many others, it followed healthy people for a long time, an average
of 6.8 years, to see who came down with Alzheimer's disease. The
investigators also had impeccable records of the patients' use of medicines.

"It's a fantastic study, and they showed a very powerful effect," said Dr.
Breitner, who is directing a study of anti-inflammatory drugs in people at
risk of becoming ill with Alzheimer's.

A potential flaw in the Dutch study is that the scientists did not randomly
assign people to take active drugs or dummy pills for comparison purposes.
For that reason, they cannot be certain it was the drugs and not some other
characteristic of the patients that made the difference.

Because the drugs have side effects like serious, sometimes fatal, stomach
bleeding, medical experts advise healthy people to await the results of
randomized trials now under way before taking anti-inflammatory drugs other
than aspirin in the hope of preventing Alzheimer's.

A strength of the study is that the researchers had highly reliable
information about what drugs the participants took, because for most of the
study period nonsteroidal anti- inflammatory drugs were available in the
Netherlands only by prescription, and the Dutch keep excellent records on
the use of prescription drugs.

By contrast, in earlier studies, researchers had no good way of knowing
what drugs people had taken. Some studies with patients suggested that
anti-inflammatories prevented Alzheimer's, whereas others did not.

Studies in the laboratory and in animals had also suggested that anti-
inflammatory drugs prevented Alzheimer's disease or delayed its onset.

Alzheimer's disease experts say that clinical trials that may confirm or
refute the Dutch study will be completed soon.

In one study supported by the National Institute on Aging, people who
already have Alzheimer's disease are taking either dummy pills or
anti-inflammatory drugs to see whether the drugs can slow the progression
of the disease. The researchers will have an answer by the middle of 2002,
said Dr. Neil Buckholtz, chief of the Dementias of Aging branch at the

Another study, also supported by the institute, involves healthy people 70
or older with family histories of Alzheimer's. Those subjects, too, are
taking anti-inflammatories or dummy pills. That study will take at least
five more years, Dr. Buckholtz said.

For now, said Dr. Steven DeKosky, who directs the Alzheimer's Disease
Research Center at the University of Pittsburgh, the Dutch study is

"This is solid circumstantial evidence," Dr. DeKosky said. "It is probably
the strongest evidence so far that anti-inflammatory drugs can quiet things
down perhaps enough to delay the onset of the disorder.

"Now it's up to the clinical trials to show us whether or not they are an
effective prevention or an effective treatment strategy."

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Damien Broderick

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