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
[61]   PATTERNS OF INTERCHANGE IN THE DISPENSING OF NONSTEROIDAL ANTIINFLAMMATORY DRUGS [J].
WALKER, AM ;
CHAN, KWA ;
YOOD, RA .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1992, 45 (02) :187-195
[62]  
Wall R T 3rd, 1990, Clin Geriatr Med, V6, P345
[63]   COMPLETENESS OF PRESCRIPTION RECORDING IN OUTPATIENT MEDICAL RECORDS FROM A HEALTH-MAINTENANCE-ORGANIZATION [J].
WEST, SL ;
STROM, BL ;
FREUNDLICH, B ;
NORMAND, E ;
KOCH, G ;
SAVITZ, DA .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1994, 47 (02) :165-171
[64]   ASSOCIATION OF EDUCATION WITH INCIDENCE OF COGNITIVE IMPAIRMENT IN 3 ESTABLISHED POPULATIONS FOR EPIDEMIOLOGIC STUDIES OF THE ELDERLY [J].
WHITE, L ;
KATZMAN, R ;
LOSONCZY, K ;
SALIVE, M ;
WALLACE, R ;
BERKMAN, L ;
TAYLOR, J ;
FILLENBAUM, G ;
HAVLIK, R .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1994, 47 (04) :363-374
[65]  
WYSENBEEK AJ, 1988, CLIN EXP RHEUMATOL, V6, P399
[66]  
1993, MED LETT, V35, P1