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Reference: Breitner, 2011
Cohort: Adult Changes in Thought-Group Health Cooperative
Risk Factor: Non-Steroidal Anti-Inflammatory Drugs


Exposure Detail
Investigators ascertained the exposure information via in-person interviews at baseline and at biennial follow-up visits. Information on prescriptions, such as drug name, strength, and amount dispensed, was collected. The number of standard daily doses (SDDs) associated with each prescription was calculated by multiplying the amount dispensed by the strength and then dividing by the SDD. The investigators reported results separately for dosage of any NSAID use via pharmacy dispensing data only and dosage of any NSAID use via pharmacy dispensing data integrated with self-report. This entry pertains to results on dosage of any NSAID use via pharmacy dispensing data and self-report.

The investigators compared incident AD risk in three groups: the group of participants who had at least 500 SDD of any NSAIDs prescribed within two years ("Heavy use"), the group of participants who had in between 60-499 SDD of any NSAIDs prescribed within two years ("Moderate use"), and the reference group of participants who had less than 60 SDD of any NSAIDs prescribed within two years ("Light/no use"). The distribution of NSAID use by dosage was not reported.

Ethnicity Detail
The distribution of ethnicity among the "other" category was not specified.

Age Detail
The median age was 74.8 at enrollment.

Screening and Diagnosis Detail
Screening Method:
CASICognitive Abilities Screening Instrument (Teng 1994)
Neuropsych Testing

AD Diagnosis:
NINCDS ADRDA National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association Criteria (McKhann 1984)

Total Dementia Definition: Dementia via DSM IV.

"Persons scoring ≤85 [on CASI] were referred for a dementia evaluation including neuropsychological testing, medical history, physical examination, laboratory testing, and appropriate neuroimaging. Diagnoses were assigned by a multidisciplinary study team at consensus conferences.9"

Covariates & Analysis Detail
Analysis Type:
Cox proportional hazards regression

Participant age was the time axis for the Cox proportional hazards models.

"Secondary analyses included not only pharmacy-based exposures but also self-reports of NSAID use. For the self-report analyses only, heavy use of NSAIDs required a report of use on two or more successive visits. Again, exposure status over time reflected the highest category to date, whether from pharmacy or self-report data."

AD Covariates:
Aage
Eeducation
Ggender
APOE4APOE e4 genotype
BMIbody mass index
DMdiabetes mellitus
HTNhypertension
OAOsteoarthritis
PAphysical activity
SPstudy population

TD Covariates:
Aage
Eeducation
Ggender
APOE4APOE e4 genotype
BMIbody mass index
DMdiabetes mellitus
HTNhypertension
OAOsteoarthritis
PAphysical activity
SPstudy population