Relation of prescription nonsteroidal antiinflammatory drug use to cognitive function among community-dwelling elderly

被引:39
作者
Hanlon, JT
Schmader, KE
Landerman, LR
Horner, RD
Fillenbaum, GG
Pieper, CF
Wall, WE
Koronkowski, MJ
Cohen, HJ
机构
[1] DUKE UNIV, MED CTR, DEPT MED, DURHAM, NC 27710 USA
[2] DUKE UNIV, MED CTR, DEPT COMMUNITY & FAMILY MED, DIV BIOMETRY, DURHAM, NC 27710 USA
[3] DUKE UNIV, MED CTR, DEPT PSYCHIAT & BEHAV SCI, DURHAM, NC 27710 USA
[4] VET AFFAIRS MED CTR, CTR GERIATR RES EDUC & CLIN, DURHAM, NC 27705 USA
[5] UNIV N CAROLINA, SCH PHARM, CHAPEL HILL, NC USA
关键词
nonsteroidal; antiinflammatory agents; cohort studies; cognition; aged; memory;
D O I
10.1016/S1047-2797(96)00124-X
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
PURPOSE: To evaluate the relationship of nonsteroidal antiinflammatory drug (NSAID) use to level of cognitive function in community-dwelling elderly persons. METHODS: The prospective cohort study included 2765 nonproxy subjects from the Duke University Established Populations for Epidemiologic Studies of the Elderly who were cognitively intact at baseline (1986-1987) and alive at follow-up three year later. Cognitive function was assessed by the Short Portable Mental Status Questionnaire (i.e., intact vs. impaired and change in score) and by the individual domains of the Orientation-Memory-Concentration Test (i.e., number of errors). NSAID use, determined from in-home interviews, was coded for chronicity, dose, frequency of use, and prescription status. RESULTS: After controlling for demographic factors as well as hearth status and behavior, continuous, regularly scheduled, prescription use of NSAID was associated with preservation of one aspect of cognitive functioning: concentration (beta coefficient, 0.29; 95% confidence interval [CI] -0.54 to -0.04, indicating fewer errors). However, no consistent dose-response relationship was found. Current and prior NSAID use was unrelated to level of cognitive functioning across all five measures; among current users, those taking moderate or high doses (beta coefficient, 0.41; 95% CI, 0.08 to 0.74) made more errors on the memory test compared with those taking low doses (beta coefficient 0.03; 95% CI, -.85 to 0.91). CONCLUSIONS: These results suggest no substantial or consistent protective effect of prescription NSAID use on cognitive function in community-dwelling elderly. However, recent use at higher doses may be associated with memory deterioration in this population. (C) 1997 by Elsevier Science Inc.
引用
收藏
页码:87 / 94
页数:8
相关论文
共 66 条
[21]   SENSITIVITY AND SPECIFICITY OF STANDARDIZED SCREENS OF COGNITIVE IMPAIRMENT AND DEMENTIA AMONG ELDERLY BLACK-AND-WHITE COMMUNITY RESIDENTS [J].
FILLENBAUM, G ;
HEYMAN, A ;
WILLIAMS, K ;
PROSNITZ, B ;
BURCHETT, B .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1990, 43 (07) :651-660
[22]   PRESCRIPTION AND NONPRESCRIPTION DRUG-USE AMONG BLACK-AND-WHITE COMMUNITY-RESIDING ELDERLY [J].
FILLENBAUM, GG ;
HANLON, JT ;
CORDER, EH ;
ZIQUBUPAGE, T ;
WALL, WE ;
BROCK, D .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1993, 83 (11) :1577-1582
[24]   SCORING NONRESPONSE ON THE MINI-MENTAL STATE EXAMINATION [J].
FILLENBAUM, GG ;
GEORGE, LK ;
BLAZER, DG .
PSYCHOLOGICAL MEDICINE, 1988, 18 (04) :1021-1025
[25]   MINI-MENTAL STATE - PRACTICAL METHOD FOR GRADING COGNITIVE STATE OF PATIENTS FOR CLINICIAN [J].
FOLSTEIN, MF ;
FOLSTEIN, SE ;
MCHUGH, PR .
JOURNAL OF PSYCHIATRIC RESEARCH, 1975, 12 (03) :189-198
[26]   TRENDS IN THE UTILIZATION OF NONSTEROIDAL ANTIINFLAMMATORY DRUGS IN THE UNITED-STATES, 1986-1990 [J].
GABRIEL, SE ;
FEHRING, RA .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1992, 45 (09) :1041-1044
[27]   COGNITIVE DYSFUNCTION ASSOCIATED WITH NAPROXEN AND IBUPROFEN IN THE ELDERLY [J].
GOODWIN, JS ;
REGAN, M .
ARTHRITIS AND RHEUMATISM, 1982, 25 (08) :1013-1015
[28]   PARANOID PSYCHOSIS WITH INDOMETHACIN [J].
GOTZ, V .
BRITISH MEDICAL JOURNAL, 1978, 1 (6104) :49-49
[29]  
HANLON J T, 1989, Journal of Geriatric Drug Therapy, V3, P5
[30]   Is medication use by community-dwelling elderly people influenced by cognitive function? [J].
Hanlon, JT ;
Landerman, LR ;
Wall, WE ;
Horner, RD ;
Fillenbaum, GG ;
Dawson, DV ;
Schmader, KE ;
Cohen, MJ ;
Blazer, DG .
AGE AND AGEING, 1996, 25 (03) :190-196