title: Steroid and nonsteroidal anti-inflammatory drugs, cognitive decline, and dementia.
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.
authors: Inserm, U1061, Montpellier, France. marie-laure.ancelin@inserm.fr
authors: Marie-Laure
authors: ML
authors: Ancelin
authors: Isabelle
authors: I
authors: Carrière
authors: Catherine
authors: C
authors: Helmer
authors: Olivier
authors: O
authors: Rouaud
authors: Florence
authors: F
authors: Pasquier
authors: Claudine
authors: C
authors: Berr
authors: Isabelle
authors: I
authors: Chaudieu
authors: Karen
authors: K
authors: Ritchie
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology*; D015331:Cohort Studies; D003704:Dementia / Q000139:chemically induced* / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D012111:Residence Characteristics; D012189:Retrospective Studies; D013256:Steroids / Q000009:adverse effects*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013256:Steroids