Steroid and nonsteroidal anti-inflammatory drugs, cognitive decline, and dementia.Reportar como inadecuado

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* Corresponding author 1 Neuropsychiatrie : recherche épidémiologique et clinique 2 Epidémiologie et Biostatistique Bordeaux 3 Laboratoire d-Explorations du Système Nerveux 4 Service de Neurologie Lille 5 Neuroscience Division

Abstract : The aim of this study was to evaluate the effects of anti-inflammatory intake on cognitive function in 7234 community-dwelling elderly persons. Cognitive performance, clinical diagnosis of dementia, and anti-inflammatory use were evaluated at baseline, and 2, 4, and 7 years later. Multivariate logistic regression analyses were adjusted for sociodemographic, behavioral, physical, mental health variables, and genetic vulnerability apolipoprotein E ε4. Elderly women taking inhaled corticosteroids were at increased risk for cognitive decline over 7 years in executive functioning odds ratio, 1.76; 95% confidence interval, 1.14-2.71; p = 0.04; the effect being increased after continuous use odds ratio, 3.15; 95% confidence interval, 1.29-7.68; p = 0.01 and not found after discontinuation of treatment. In men, no significant associations were observed. Corticosteroid use was not significantly associated with an increase risk of incident dementia over 7 years. Nonsteroidal anti-inflammatory drug use was not significantly associated with either dementia incidence or cognitive decline in both sexes. The association may be related to hypothalamic-pituitary-adrenal corticotropic axis dysfunctioning rather than a direct anti-inflammatory mechanism. Long-term use of inhaled corticosteroids may constitute a form of reversible cognitive disorder in elderly women. Physicians should check this possibility before assuming neurodegenerative changes.

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Keywords : Corticosteroids Nonsteroidal anti-inflammatory drugs Cognitive aging Alzheimer-s disease Elderly Apolipoprotein E Prospective cohort.

keyword : Prospective cohort

Autor: Marie-Laure Ancelin - Isabelle Carrière - Catherine Helmer - Olivier Rouaud - Florence Pasquier - Claudine Berr - Isabelle Chaud



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