Nonsteroidal anti-inflammatory drug use and the risk for Alzheimer's disease: dissecting the epidemiological evidence.

Inflammation is hypothesised to contribute to the genesis of pathology causing or contributing to Alzheimer's disease (AD). As a part of the immune response in the brain, the prostaglandin pathway is induced; this pathway is the target for NSAIDs, the most widely used anti-inflammatory medication. There are many epidemiological studies, which are reviewed here, suggesting NSAIDs reduce the risk for AD. The most recent of these studies suggest NSAIDs should be taken for at least 2 years. There are little data in humans about whether one type of NSAID is more effective than another. To date, randomised, double-blind, clinical trials in patients with AD have been negative. There is one prevention trial that will yield valuable information about the efficacy of NSAIDs in slowing down the progression of, or preventing, AD. At present, no recommendations can be made concerning the when, what, who and for how long a person should take an NSAID to reduce his or her risk for AD.