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Risk Factor:
  (anti-inflammatory medication, NSAIDs)
Risk Factor Type: Medications
Current Understanding:
The tables below summarize results from a modest number of reports that collectively show no association between use of non-steroidal anti-inflammatory drugs (NSAIDs) and the risk of Alzheimer disease dementia (AD) and total dementia. The results from observational studies are consistent with null findings from a randomized, double-blinded, placebo-controlled trial involving naproxen and celecoxib, which was halted early for safety concerns. While non-aspirin NSAID use (current, ever) assessed at the time of AD evaluation showed a protective association against AD risk, non-aspirin NSAID use assessed in years prior to AD evaluation showed no such association. Because by definition AD does not have an acute onset, but rather progresses over a number of years, the discrepancy in findings indicates that the time-updated analyses may not accurately reflect the association between NSAID use and AD risk. Studies that report time-updated results are particularly susceptible to bias from reverse causation, as individuals with cognitive decline may be less likely to be taking NSAIDs. Observational studies involving aspirin use show a marginally protective effect, although these results may be undermined by confounding by indication, healthy user bias, or selection bias. Because there are known risks to NSAID use, including cardiovascular events and gastrointestinal bleeding and ulceration, future studies examining the effect of NSAIDs by dose, duration, and timing on AD risk will likely be limited to observational studies. Because of these significant safety concerns and lack of evidence of any benefit, NSAID use is definitely not recommended to prevent AD. For a more in depth commentary, please see the Discussion.
Literature Extraction: Search strategy  * New *
Last Search Completed: 04 April 2015

Table 1:  Use of non-steroidal anti-inflammatory drugs (ever vs. never)
Table 2:  Use of non-steroidal anti-inflammatory drugs (current vs. not using)
Table 3:  Use of non-steroidal anti-inflammatory drugs (current vs. former vs. never)
Table 4:  Use of non-steroidal anti-inflammatory drugs by duration
Table 5:  Use of non-steroidal anti-inflammatory drugs by dosage
Table 6:  Use of non-aspirin non-steroidal anti-inflammatory drugs (ever vs. never)
Table 7:  Use of non-aspirin non-steroidal anti-inflammatory drugs (current vs. not using)
Table 8:  Use of non-aspirin non-steroidal anti-inflammatory drugs (current vs. former vs. never)
Table 9:  Use of non-aspirin non-steroidal anti-inflammatory drugs by duration
Table 10:  Use of non-aspirin non-steroidal anti-inflammatory drugs by dosage
Table 11:  Use of aspirin (ever vs. never)
Table 12:  Use of aspirin (current vs. not using)
Table 13:  Use of aspirin by duration

Table 1:   Use of non-steroidal anti-inflammatory drugs (ever vs. never)
Notes These reports examined use of NSAIDs, without distinction to agent or class, in relation to Alzheimer disease (AD) risk. Some reports evaluated use at baseline, whereas others incorporated updates to NSAID use after baseline (also called time-updated use) and effectively evaluated use at the time of the diagnostic assessment or 2 years prior (also called lag). Reported estimates compared AD risk among persons who ever used NSAIDs with risk among persons who never used NSAIDs.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Stewart, 1997 BLSA Incidence study reporting hazard ratios (HRs) 1686
(42%)		 8.0 y
*
(detail)
Use at time of AD evaluation
Never used: 74%
Ever used: 26%
(detail)
-
-
Total: 81
1.00
0.50
Ref.
0.30-0.85
Ref.
0.01
*
 
 
 
 
 		 Caucasian
 - (-)
( - )
(detail)		 Screening: Blessed, MMSE, Pfeffer FAQ, TMT

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, G, FUT‡
(detail)		 Stewart, 1997
Stewart, 1997 BLSA Incidence study reporting hazard ratios (HRs) 1686
(42%)		 8.0 y
*
(detail)
Use 2 y prior to AD evaluation
Never used: 74%
Ever used: 26%
(detail)
-
-
Total: 81
1.00
0.52
Ref.
0.30-0.91
Ref.
0.02
*
 
 
 
 
 		 Caucasian
 - (-)
( - )
(detail)		 Screening: Blessed, MMSE, Pfeffer FAQ, TMT

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, G, FUT‡
(detail)		 Stewart, 1997
Tyas, 2001 MSHA Cumulative incidence study reporting odds ratios (ORs) 694
(62%)		 5.0 y
(detail)
Baseline use
Never used: 67%
Ever used: 33%
(detail)
19
13
Total: 32
1.00
1.75
Ref.
0.81-3.75
Ref.
0.15
*
 
 
 
 
 		  (detail) 74 (6)
(65 - 93)
(detail)		 Screening: 3MSE, Neuropsych Testing

AD Diagnosis: NINDS-AIREN
(detail)		 A, E, G‡
(detail)		 Tyas, 2001
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "FUT" (follow up time)
 
Table 2:   Use of non-steroidal anti-inflammatory drugs (current vs. not using)
Notes These reports examined use of NSAIDs, without distinction to agent or class, at baseline in relation to Alzheimer disease (AD) risk. All reported estimates compared AD risk among persons who were currently using NSAIDs with AD risk among persons who were not using NSAIDs at baseline.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Cornelius, 2004 Kungsholmen Project Incidence study reporting hazard ratios (HRs) 1301
(75%)		 4.1 y
*
Baseline use
Not using: 83%
Current use: 17%
(detail)
-
-
Total: 257
1.00
1.11
Ref.
0.81-1.52
Ref.
0.52
*
65
285
Total: 350
1.00
1.03
Ref.
0.78-1.35
Ref.
0.83
*		 Swedish
(detail)		 - (-)
( - ≥ 75)
(detail)		 Screening: MMSE

AD Diagnosis: DSM IIIR, Hachinski's Ischemic Scale (Hachinski, 1975)
(detail)		 A, E, G‡
(detail)		 Cornelius, 2004
Côté, 2012 CSHA Incidence study reporting hazard ratios (HRs) 4916
(61%)		 10 y
(detail)
Baseline use
Not using NSAIDs: 43%
Current use: 57%
(detail)
205
230
Total: 435
1.00
0.79
Ref.
0.66-0.96
Ref.
0.01
*
281
349
Total: 630
1.00
0.89
Ref.
0.76-1.04
Ref.
0.15
*		 Other
(detail)		 76 (7)
( - ≥ 65)
(detail)		 Screening: 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, ALC, AOS, CVRF, CI, MG, OA, PA, SM‡
(detail)		 Côté, 2012
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "ALC" (alcohol intake), "AOS" (antioxidative Supplements), "CVRF" (cardiovascular risk factors), "CI" (comorbidity index), "IY" (index year), "MG" (Migraine), "OA" (Osteoarthritis), "PA" (physical activity), "SM" (smoking status)
 
Table 3:   Use of non-steroidal anti-inflammatory drugs (current vs. former vs. never)
Notes This report examined use of NSAIDs, without distinction to agent or class, at 3 years prior to diagnostic assessment in relation to Alzheimer disease (AD) risk (also called time-updated use). Reported estimates compared AD risk among persons with current, former, or continuous NSAID use with AD risk among never users of NSAIDs.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Wolfson, 2002 CSHA Nested case control study with cumulative incidence sampling reporting odds ratios (ORs) 599
(67%)		 3.0 y
(detail)
Use at 3 y prior to AD evaluation
Never use: 43%
Current use: 7%
Former use: 20%
Continuous use: 30%
(detail)
19
1
7
9
Total: 36
1.00
0.26†
0.86
0.74
Ref.
0.03-2.01
0.34-2.14
0.32-1.71
Ref.
0.21
0.75
0.48
*
 
 
 
 
 
 
 		 Other
(detail)		 - (-)
( - ≥ 75)
(detail)		 Screening: 3MSE

AD Diagnosis: DSM IIIR, NINCDS ADRDA, Neurologic examination
(detail)		 A, G, IY‡
(detail)		 Wolfson, 2002
* Derived value.
 † Five or fewer cases exist.
 ‡ Covariates: "A" (age), "G" (gender), "IY" (index year)
 
Table 4:   Use of non-steroidal anti-inflammatory drugs by duration
Notes These reports examined use of NSAIDs, without distinction to agent or class, in relation to Alzheimer (AD) risk. Some reports evaluated use at baseline, whereas others incorporated updates to NSAID use after baseline (also called time-updated use) and effectively evaluated use at the time of diagnostic assessment or 2 to 3 years prior (also called lag). Reported estimates compared AD risk by duration of NSAID use, modeled as a categorical variable.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Fischer, 2008 VITA Cohort study reporting odds ratios (ORs) 479
(61%)		 2.6 y
(detail)
Baseline use
Non-use: 88%
≤2 years: 5%
>2 years: 7%
(detail)
86
2
2
Total: 90
1.00
0.40†
0.40†
Ref.
0.20-0.81
0.20-0.81
Ref.
0.01
0.01
 
 
 
 
 
 		 Other
(detail)		 76 (0)
( - )
(detail)		 Screening: CERAD

AD Diagnosis: DSM IV, NINCDS ADRDA
(detail)		  
(detail)		 Fischer, 2008
Stewart, 1997 BLSA Incidence study reporting hazard ratios (HRs) 1686
(42%)		 8.0 y
*
(detail)
Use at time of AD evaluation
Never used:         
<2 years:         
2+ years:         
(detail)
-
-
-
Total: 81
1.00
0.52
0.46
Ref.
0.25-1.12
0.24-0.86
Ref.
0.09
0.02
*
 
 
 
 
 
 		 Caucasian
 - (-)
( - )
(detail)		 Screening: Blessed, MMSE, Pfeffer FAQ, TMT

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, G, FUT‡
(detail)		 Stewart, 1997
Stewart, 1997 BLSA Incidence study reporting hazard ratios (HRs) 1686
(42%)		 8.0 y
*
(detail)
Use 2 y prior to AD evaluation
Never used:         
<2 years:         
2+ years:         
(detail)
-
-
-
Total: 81
1.00
0.65
0.40
Ref.
0.33-1.29
0.19-0.84
Ref.
0.22
0.02
*
 
 
 
 
 
 		 Caucasian
 - (-)
( - )
(detail)		 Screening: Blessed, MMSE, Pfeffer FAQ, TMT

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, G, FUT‡
(detail)		 Stewart, 1997
Wolfson, 2002 CSHA Nested case control study with cumulative incidence sampling reporting odds ratios (ORs) 599
(67%)		 3.0 y
(detail)
Use 3 y prior to AD evaluation
0 days of use: 43%
1-360 days of use: 43%
≥ 361 days of use: 15%
(detail)
19
12
5
Total: 36
1.00
0.67
0.82†
Ref.
0.31-1.43
0.29-2.33
Ref.
0.3
0.71
*
 
 
 
 
 
 		 Other
(detail)		 - (-)
( - ≥ 75)
(detail)		 Screening: 3MSE

AD Diagnosis: DSM IIIR, NINCDS ADRDA, Neurologic examination
(detail)		 A, G, IY‡
(detail)		 Wolfson, 2002
* Derived value.
 † Five or fewer cases exist.
 ‡ Covariates: "A" (age), "G" (gender), "FUT" (follow up time), "IY" (index year)
 
Table 5:   Use of non-steroidal anti-inflammatory drugs by dosage
Notes These reports examined use of NSAIDs, without distinction to agent or class, at the time of the diagnostic assessment in relation to Alzheimer disease (AD) risk (also called time-updated use). These reports evaluated the relation of NSAID dosage, modeled as a categorical variable, to risk of incident AD.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Breitner, 2011 ACT-GHC Incidence study reporting hazard ratios (HRs) 2736
(60%)		 -
Pharmacy only, use at time of AD evaulation
Light/no use: 50%
Moderate use: 37%
Heavy use: 13%
(detail)
129
154
73
Total: 356
1.00
1.26
1.57
Ref.
0.97-1.65
1.10-2.23
Ref.
0.09
0.01
*
173
198
105
Total: 476
1.00
1.13
1.66
Ref.
0.90-1.43
1.24-2.24
Ref.
0.3
0.001
*		 Caucasian, Other
(detail)		 75 (-)
( - ≥ 65)
(detail)		 Screening: CASI, Neuropsych Testing

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4, BMI, DM, HTN, OA, PA, SP‡
(detail)		 Breitner, 2011
Breitner, 2011 ACT-GHC Incidence study reporting hazard ratios (HRs) 2095
(60%)		 -
Pharmacy and self-report, use at time of AD evaulation
Light/no use:         
Moderate use:         
Heavy use:         
(detail)
97
112
70
Total: 279
1.00
1.15
1.55
Ref.
0.85-1.57
1.07-2.24
Ref.
0.37
0.02
*
-
-
-
1.00
1.07
1.61
Ref.
0.82-1.40
1.17-2.21
Ref.
0.62
0.003
*		 Caucasian, Other
(detail)		 75 (-)
( - ≥ 65)
(detail)		 Screening: CASI, Neuropsych Testing

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4, BMI, DM, HTN, OA, PA, SP‡
(detail)		 Breitner, 2011
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "APOE4" (APOE e4 genotype), "BMI" (body mass index), "DM" (diabetes mellitus), "HTN" (hypertension), "OA" (Osteoarthritis), "PA" (physical activity), "SP" (study population)
 
Table 6:   Use of non-aspirin non-steroidal anti-inflammatory drugs (ever vs. never)
Notes These reports examined use of non-aspirin NSAIDs in relation to Alzheimer disease (AD) risk. Some reports evaluated use at baseline, whereas others incorporated updates to non-aspirin NSAID use after baseline (also called time-updated use) and effectively evaluated use at the time of the diagnostic assessment or up to 2 years prior (also called lag). Non-aspirin NSAID use was also referred to as "traditional" NSAID use in some papers. Reported estimates compared AD risk among persons who ever used non-aspirin NSAIDs with risk among persons who never used non-aspirin NSAIDs.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Arvanitakis, 2008 ROS Incidence study reporting hazard ratios (HRs) 1019
(69%)		 -
(detail)
Cumulative use at time of AD evaluation
Never used:         
Always used:         
(detail)
-
-
Total: 209
1.00
1.04
Ref.
0.78-1.38
Ref.
0.79
*
 
 
 
 
 		 Caucasian
(detail)		 75 (-)
( - )		 Screening: CERAD, Neuropsych Testing

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G‡
(detail)		 Arvanitakis, 2008
In 'T Veld, 1998 Rotterdam Study Nested case control study with cumulative incidence sampling reporting odds ratios (ORs) 306
(73%)		 3.0 y
(detail)
Exposure window of 2-0.5 years before diagnosis
Never used: 78%
Ever used: 22%
(detail)
53
21
Total: 74
1.00
1.41
Ref.
0.65-3.05
Ref.
0.38
*
 
 
 
 
 		  (detail) - (-)
( - ≥ 55)		 Screening: CAMDEX, GMS, MMSE

AD Diagnosis: Brain Imaging, DSM IIIR, NINCDS ADRDA, Neurologic examination, Neuropsychological examination
(detail)		 A, E, G, ALC, ASP, Benzo, HYS, ALON, SH‡
(detail)		 In 'T Veld, 1998
In 'T Veld, 2001 Rotterdam Study Incidence study reporting hazard ratios (HRs) 6989
(60%)		 6.8 y
(detail)
Use at time of AD evaluation
Never used:         
Ever used:         
(detail)
-
-
Total: 293
1.00
0.86
Ref.
0.66-1.09
Ref.
0.24
*
 
 
 
 
 		 Dutch
(detail)		 - (-)
( - ≥ 55)
(detail)		 Screening: Brain Imaging, CAMDEX, GMS, MMSE, Neuropsych Testing

AD Diagnosis: DSM IIIR, NINDS-AIREN, NINCDS ADRDA
(detail)		 A, E, G, AHD, H2A, HGU, SM‡
(detail)		 In 'T Veld, 2001
Szekely, 2008 CHCS Incidence study reporting hazard ratios (HRs) 3229
(60%)		 -
(detail)
Use at time of AD evaluation
Never used: 63%
Ever used: 37%
(detail)
175
56
Total: 231
1.00
0.63
Ref.
0.45-0.88
Ref.
0.01
*
337
115
Total: 452
1.00
0.76
Ref.
0.60-0.96
Ref.
0.02
*		 Caucasian, Other, African-American (Black)
 - (-)
( - ≥ 65)
(detail)		 Screening: 3MSE, Other

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4, MMSE, RE‡
(detail)		 Szekely, 2008
Szekely, 2008b SPC Incidence study reporting hazard ratios (HRs) 13499
(59%)		 -
(detail)
Use at time of AD evaluation
Never used: 70%
Ever Used: 30%
(detail)
642
178
Total: 820
1.00
0.77
Ref.
0.65-0.91
Ref.
0.002
*
 
 
 
 
 		 Caucasian, Other, African-American (Black)
(detail)		 - (-)
( - )
(detail)		 AD Diagnosis: Brain Imaging, DSM IIIR, DSM IV, NINCDS ADRDA, Neurologic examination
(detail)		 A, E, G, OA, SP‡
(detail)		 Szekely, 2008b
Szekely, 2008b SPC Incidence study reporting hazard ratios (HRs) 13457
(-)		 -
(detail)
Use at time of AD evaluation
Never use: 71%
SALA use: 19%
Non-SALA use: 6%
SALA and non-SALA use: 4%
(detail)
642
127
25
23
Total: 817
1.00
0.82
0.60
0.87
Ref.
0.67-0.99
0.40-0.90
0.57-1.33
Ref.
0.05
0.01
0.52
*
 
 
 
 
 
 
 		 Caucasian, Other, African-American (Black)
(detail)		 - (-)
( - )
(detail)		 AD Diagnosis: Brain Imaging, DSM IIIR, DSM IV, NINCDS ADRDA, Neurologic examination
(detail)		 A, E, G, OA, SP‡
(detail)		 Szekely, 2008b
Tyas, 2001 MSHA Cumulative incidence study reporting odds ratios (ORs) 694
(62%)		 5.0 y
(detail)
Baseline use
Never used: 88%
Ever used: 12%
(detail)
28
4
Total: 32
1.00
1.27†
Ref.
0.41-3.96
Ref.
0.68
*
 
 
 
 
 		  (detail) 74 (6)
(65 - 93)
(detail)		 Screening: 3MSE, Neuropsych Testing

AD Diagnosis: NINDS-AIREN
(detail)		 A, E, G‡
(detail)		 Tyas, 2001
Zandi, 2002 Cache County Study Incidence study reporting hazard ratios (HRs) 3227
(-)		 3.1 y
*
Baseline use
Never used: 70%
Ever used: 29%
(detail)
79
22
Total: 101
1.00
0.67
Ref.
0.40-1.06
Ref.
0.11
*
 
 
 
 
 		 Caucasian
(detail)		 74 (6)
( - ≥ 65)
(detail)		 Screening: DQ, DSM IIIR - dementia, IQ-CODE, 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4‡
(detail)		 Zandi, 2002
* Derived value.
 † Five or fewer cases exist.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "ALC" (alcohol intake), "AHD" (antihypertensive drug use), "APOE4" (APOE e4 genotype), "ASP" (aspirin ), "MMSE" (baseline MMSE), "Benzo" (Benzodiazepine), "H2A" (histamine H-2 receptor antagonists use), "HYS" (history of hysterectomy), "HGU" (hypoglycemic drug use), "ALON" (living alone), "OA" (Osteoarthritis), "RE" (race/ethnicity), "SM" (smoking status), "SH" (stroke history), "SP" (study population)
 
Table 7:   Use of non-aspirin non-steroidal anti-inflammatory drugs (current vs. not using)
Meta-Analysis
Notes These reports examined use of non-aspirin NSAID use at baseline in relation to Alzheimer disease (AD) risk. All reported estimates compared AD risk among persons who were currently using non-aspirin NSAIDs with AD risk among persons who were not using non-aspirin NSAIDs at baseline. Non-aspirin NSAID use was also referred to as "traditional" NSAID use in some papers. This table also contains information from the Alzheimer's Disease Anti-Inflammatory Prevention Trial (ADAPT), in which investigators compared AD risk among persons who were randomly assigned to use non-aspirin NSAIDs with AD risk among persons who were randomly assigned to not use non-aspirin NSAIDs (i.e., intention-to-treat analysis).  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
ADAPT, 2013 ADAPT Incidence study reporting hazard ratios (HRs) 1537
(46%)		 3.2 y
*
(detail)
Intention to treat
Placebo: 43%
Celecoxib use: 29%
(detail)
40
24
Total: 64
1.00
1.03
Ref.
0.72-1.50
Ref.
0.86
44
27
Total: 71
1.00
1.03
Ref.
0.72-1.46
Ref.
0.88		 Caucasian, Other, Hispanic, African-American (Black)
 74 (-)
( - )
(detail)		 Screening: Neuropsych Testing, TELE

AD Diagnosis: DSM IV, NINCDS ADRDA
(detail)		 A, CC‡
(detail)		 ADAPT, 2013
ADAPT, 2013 ADAPT Incidence study reporting hazard ratios (HRs) 1537
(46%)		 3.2 y
*
(detail)
Intention to treat
Placebo: 43%
Naproxen use: 29%
(detail)
40
25
Total: 65
1.00
0.92
Ref.
0.62-1.35
Ref.
0.66
44
28
Total: 72
1.00
0.94
Ref.
0.65-1.35
Ref.
0.72		 Caucasian, Other, Hispanic, African-American (Black)
 74 (-)
( - )
(detail)		 Screening: Neuropsych Testing, TELE

AD Diagnosis: DSM IV, NINCDS ADRDA
(detail)		 A, CC‡
(detail)		 ADAPT, 2013
Ancelin, 2012b 3C Incidence study reporting hazard ratios (HRs) 4573
(100%)		 6.7 y
(detail)
Women only, baseline use
Not using: 90%
Current use: 10%
(detail)
-
-
Total: 226
1.00
1.32
Ref.
0.86-2.03
Ref.
0.21
-
-
Total: 320
1.00
1.27
Ref.
0.88-1.83
Ref.
0.2		 Other, French
(detail)		 74 (5)
( - ≥ 65)		 Screening: BVRT, IST, MMSE, TMT

AD Diagnosis: DSM IV, Neurologic examination
(detail)		 A, E, G, APOE4, ASM, BRN, JNTPN, CC, DEP, DM, HICAF, HC, IHD, SM‡
(detail)		 Ancelin, 2012b
Ancelin, 2012b 3C Incidence study reporting hazard ratios (HRs) 2913
(0%)		 6.7 y
(detail)
Men only, baseline use
Not using: 94%
Current use: 6%
(detail)
-
-
Total: 134
1.00
1.01
Ref.
0.49-2.09
Ref.
0.97
-
-
Total: 207
1.00
0.88
Ref.
0.48-1.63
Ref.
0.69		 Other, French
(detail)		 74 (5)
( - ≥ 65)		 Screening: BVRT, IST, MMSE, TMT

AD Diagnosis: DSM IV, Neurologic examination
(detail)		 A, E, G, APOE4, ASM, BRN, JNTPN, CC, DEP, DM, HICAF, HC, IHD, SM‡
(detail)		 Ancelin, 2012b
Arvanitakis, 2008 ROS Incidence study reporting hazard ratios (HRs) 1019
(69%)		 -
(detail)
Baseline use
Not using: 79%
Current use: 21%
(detail)
154
55
Total: 209
1.00
1.19
Ref.
0.87-1.62
Ref.
0.27
*
 
 
 
 
 		 Caucasian
(detail)		 75 (-)
( - )		 Screening: CERAD, Neuropsych Testing

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G‡
(detail)		 Arvanitakis, 2008
Cornelius, 2004 Kungsholmen Project Incidence study reporting hazard ratios (HRs) 1301
(75%)		 4.1 y
*
Baseline use
Not using: 94%
Current use: 6%
(detail)
-
-
Total: 257
1.00
0.61
Ref.
0.32-1.15
Ref.
0.13
*
333
17
Total: 350
1.00
0.79
Ref.
0.49-1.29
Ref.
0.34
*		 Swedish
(detail)		 - (-)
( - ≥ 75)
(detail)		 Screening: MMSE

AD Diagnosis: DSM IIIR, Hachinski's Ischemic Scale (Hachinski, 1975)
(detail)		 A, E, G‡
(detail)		 Cornelius, 2004
Côté, 2012 CSHA Incidence study reporting hazard ratios (HRs) 4916
(61%)		 10 y
(detail)
Baseline use
Not using NSAIDs: 50%
Current use: 50%
(detail)
232
203
Total: 435
1.00
0.99
Ref.
0.66-1.47
Ref.
0.96
*
328
302
Total: 630
1.00
1.18
Ref.
0.87-1.60
Ref.
0.29
*		 Other
(detail)		 76 (7)
(65 - )
(detail)		 Screening: 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, ALC, AOS, CVRF, CI, MG, OA, PA, SM‡
(detail)		 Côté, 2012
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "ALC" (alcohol intake), "AOS" (antioxidative Supplements), "APOE4" (APOE e4 genotype), "ASM" (asthma), "BRN" (bronchitis), "CVRF" (cardiovascular risk factors), "JNTPN" (chronic joint pain), "CC" (city center), "CI" (comorbidity index), "DEP" (depression), "DM" (diabetes mellitus), "HICAF" (high caffeine intake), "HC" (high cholesterol), "IHD" (ischemic heart disease), "MG" (Migraine), "OA" (Osteoarthritis), "PA" (physical activity), "SM" (smoking status)
 
Table 8:   Use of non-aspirin non-steroidal anti-inflammatory drugs (current vs. former vs. never)
Notes These reports examined use of non-aspirin NSAIDs at baseline in relation to Alzheimer disease (AD) risk. Non-aspirin NSAID use was also referred to as "traditional" NSAID use in some papers. Reported estimates compared AD risk among persons with current or former non-aspirin NSAID use with AD risk among never users of non-aspirin NSAIDs at baseline.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Zandi, 2002 Cache County Study Incidence study reporting hazard ratios (HRs) 3227
(58%)		 3.1 y
*
Baseline use
Never use: 71%
Former use: 12%
Current use: 17%
(detail)
79
-
-
Total: 101
1.00
0.42
0.85
Ref.
0.16-0.90
0.47-1.44
Ref.
0.05
0.57
*
 
 
 
 
 
 		 Caucasian
(detail)		 74 (6)
( - ≥ 65)
(detail)		 Screening: DQ, DSM IIIR - dementia, IQ-CODE, 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4‡
(detail)		 Zandi, 2002
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "APOE4" (APOE e4 genotype)
 
Table 9:   Use of non-aspirin non-steroidal anti-inflammatory drugs by duration
Notes These reports examined use of non-aspirin NSAIDs in relation to Alzheimer disease (AD) risk. Some reports evaluated use at baseline, whereas others incorporated updates to NSAID use after baseline (also called time-updated use) and effectively evaluated use at the time of diagnostic assessment or 2 to 10 years prior (also called lag). Non-aspirin NSAID use was also referred to as "traditional" NSAID use in some papers. Reported estimates compared AD risk by duration of non-aspirin NSAID use, modeled as a categorical variable.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
In 'T Veld, 1998 Rotterdam Study Nested case control study with cumulative incidence sampling reporting odds ratios (ORs) 306
(73%)		 3.0 y
(detail)
Exposure window of 10-0.5 years before diagnosis
Non-use: 35%
Short-term use: 35%
Intermediate-term use: 21%
Long-term use: 9%
(detail)
24
27
19
4
Total: 74
1.00
1.08
1.03
0.74†
Ref.
0.50-2.33
0.46-2.31
0.20-2.72
Ref.
0.84
0.94
0.65
*
 
 
 
 
 
 
 		  (detail) - (-)
( - ≥ 55)		 Screening: CAMDEX, GMS, MMSE

AD Diagnosis: Brain Imaging, DSM IIIR, NINCDS ADRDA, Neurologic examination, Neuropsychological examination
(detail)		 A, E, G, ALC, ASP, Benzo, HYS, ALON, SH‡
(detail)		 In 'T Veld, 1998
In 'T Veld, 1998 Rotterdam Study Nested case control study with cumulative incidence sampling reporting odds ratios (ORs) 306
(73%)		 3.0 y
(detail)
Exposure window of 10-2 years before diagnosis
Non-use: 41%
Short-term use: 35%
Intermediate-term use: 18%
Long-term use: 7%
(detail)
32
24
16
2
Total: 74
1.00
0.76
0.97
0.27†
Ref.
0.37-1.57
0.44-2.17
0.05-1.51
Ref.
0.46
0.94
0.13
*
 
 
 
 
 
 
 		  (detail) - (-)
( - ≥ 55)		 Screening: CAMDEX, GMS, MMSE

AD Diagnosis: Brain Imaging, DSM IIIR, NINCDS ADRDA, Neurologic examination, Neuropsychological examination
(detail)		 A, E, G, ALC, ASP, Benzo, HYS, ALON, SH‡
(detail)		 In 'T Veld, 1998
In 'T Veld, 2001 Rotterdam Study Incidence study reporting hazard ratios (HRs) 6989
(60%)		 6.8 y
(detail)
Cumulative use at time of AD evaluation
Non-use: 37%
Short-term use: 29%
Intermediate-term use: 32%
Long-term use: 3%
(detail)
-
-
-
-
Total: 293
1.00
0.95
0.83
0.20
Ref.
0.70-1.29
0.62-1.11
0.05-0.83
Ref.
0.74
0.21
0.02
*
 
 
 
 
 
 
 		 Dutch
(detail)		 - (-)
( - ≥ 55)
(detail)		 Screening: Brain Imaging, CAMDEX, GMS, MMSE, Neuropsych Testing

AD Diagnosis: DSM IIIR, NINDS-AIREN, NINCDS ADRDA
(detail)		 A, E, G, AHD, H2A, HGU, SM‡
(detail)		 In 'T Veld, 2001
Zandi, 2002 Cache County Study Incidence study reporting hazard ratios (HRs) 3227
(-)		 3.1 y
*
Baseline use
Never used: 70%
≤2 years:         
>2 years:         
(detail)
22
-
-
Total: 101
1.00
0.75
0.45
Ref.
0.38-1.34
0.17-0.97
Ref.
0.37
0.07
*
 
 
 
 
 
 		 Caucasian
(detail)		 74 (6)
( - ≥ 65)
(detail)		 Screening: DQ, DSM IIIR - dementia, IQ-CODE, 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4‡
(detail)		 Zandi, 2002
* Derived value.
 † Five or fewer cases exist.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "ALC" (alcohol intake), "AHD" (antihypertensive drug use), "APOE4" (APOE e4 genotype), "ASP" (aspirin ), "Benzo" (Benzodiazepine), "H2A" (histamine H-2 receptor antagonists use), "HYS" (history of hysterectomy), "HGU" (hypoglycemic drug use), "ALON" (living alone), "SM" (smoking status), "SH" (stroke history)
 
Table 10:   Use of non-aspirin non-steroidal anti-inflammatory drugs by dosage
Notes These reports examined non-aspirin NSAID use at the time of the diagnostic assessment in relation to Alzheimer disease (AD) risk (also called time-updated use). Non-aspirin NSAID use was also referred to as "traditional" NSAID use in some papers. These reports evaluated the relation of non-aspirin NSAID dosage, modeled as a categorical variable, to risk of incident AD.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
In 'T Veld, 2001 Rotterdam Study Incidence study reporting hazard ratios (HRs) 6989
(60%)		 6.8 y
(detail)
Use at time of AD evaluation
≤1 defined daily dose per day:         
>1 defined daily dose per day:         
(detail)
-
-
Total: 293
1.00
0.25
Ref.
0.03-1.78
Ref.
0.18
*
 
 
 
 
 		 Dutch
(detail)		 - (-)
( - ≥ 55)
(detail)		 Screening: Brain Imaging, CAMDEX, GMS, MMSE, Neuropsych Testing

AD Diagnosis: DSM IIIR
(detail)		 A, E, G, AHD, H2A, HGU, SM‡
(detail)		 In 'T Veld, 2001
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "AHD" (antihypertensive drug use), "H2A" (histamine H-2 receptor antagonists use), "HGU" (hypoglycemic drug use), "SM" (smoking status)
 
Table 11:   Use of aspirin (ever vs. never)
Notes These reports examined aspirin use in relation to Alzheimer disease (AD) risk. Some reports evaluated use at baseline, whereas others incorporated updates to aspirin use after baseline (also called time-updated use) and effectively evaluated use at the time of the diagnostic assessment or 2 years prior (also called lag). Aspirin was also referred to as Acetylsalicylic acid-containing medications or salicylates. Reported estimates compared AD risk among persons who ever used aspirin with risk among persons who never used aspirin.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Arvanitakis, 2008 ROS Incidence study reporting hazard ratios (HRs) 1019
(69%)		 -
(detail)
Cumulative use at time of AD evaluation
Never used:         
Always used:         
(detail)
-
-
Total: 209
1.00
0.86
Ref.
0.65-1.14
Ref.
0.29
*
 
 
 
 
 		 Caucasian
(detail)		 75 (-)
( - )		 Screening: CERAD, Neuropsych Testing

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G‡
(detail)		 Arvanitakis, 2008
Stewart, 1997 BLSA Incidence study reporting hazard ratios (HRs) 1686
(42%)		 8.0 y
*
(detail)
Use at time of AD evaluation
Never used: 59%
Ever used: 41%
(detail)
-
-
Total: 81
1.00
0.81
Ref.
0.52-1.28
Ref.
0.36
*
 
 
 
 
 		 Caucasian
 - (-)
( - )
(detail)		 Screening: Blessed, MMSE, Pfeffer FAQ, TMT

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, G, FUT‡
(detail)		 Stewart, 1997
Stewart, 1997 BLSA Incidence study reporting hazard ratios (HRs) 1686
(42%)		 8.0 y
*
(detail)
Use 2 y prior to AD evaluation
Never used: 59%
Ever used: 41%
(detail)
-
-
Total: 81
1.00
0.74
Ref.
0.46-1.18
Ref.
0.21
*
 
 
 
 
 		 Caucasian
 - (-)
( - )
(detail)		 Screening: Blessed, MMSE, Pfeffer FAQ, TMT

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, G, FUT‡
(detail)		 Stewart, 1997
Szekely, 2008 CHCS Incidence study reporting hazard ratios (HRs) 3229
(60%)		 -
(detail)
Use at time of AD evaluation
Never used: 40%
Ever used: 60%
(detail)
122
109
Total: 231
1.00
0.87
Ref.
0.65-1.16
Ref.
0.35
*
216
236
Total: 452
1.00
1.07
Ref.
0.88-1.32
Ref.
0.51
*		 Caucasian, Other, African-American (Black)
 - (-)
( - ≥ 65)
(detail)		 Screening: 3MSE, Other

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4, MMSE, RE‡
(detail)		 Szekely, 2008
Szekely, 2008b SPC Incidence study reporting hazard ratios (HRs) 13499
(59%)		 -
*
(detail)
Use at time of AD evaluation
Never used: 53%
Ever used: 47%
(detail)
385
256
Total: 641
1.00
0.78
Ref.
0.66-0.92
Ref.
0.003
*
 
 
 
 
 		 Caucasian, Other, African-American (Black)
(detail)		 - (-)
( - )
(detail)		 AD Diagnosis: Brain Imaging, DSM IIIR, DSM IV, NINCDS ADRDA, Neurologic examination
(detail)		 A, E, G‡
(detail)		 Szekely, 2008b
Tyas, 2001 MSHA Cumulative incidence study reporting odds ratios (ORs) 694
(62%)		 5.0 y
(detail)
Baseline use
Never used: 77%
Ever used: 23%
(detail)
22
10
Total: 32
1.00
1.70
Ref.
0.76-3.83
Ref.
0.2
*
 
 
 
 
 		  (detail) 74 (6)
(65 - 93)
(detail)		 Screening: 3MSE, Neuropsych Testing

AD Diagnosis: NINDS-AIREN
(detail)		 A, E, G‡
(detail)		 Tyas, 2001
Zandi, 2002 Cache County Study Incidence study reporting hazard ratios (HRs) 3227
(-)		 3.1 y
*
Baseline use
Never used: 61%
Ever used: 38%
(detail)
64
37
Total: 101
1.00
0.82
Ref.
0.54-1.23
Ref.
0.34
*
 
 
 
 
 		 Caucasian
(detail)		 74 (6)
( - ≥ 65)
(detail)		 Screening: DQ, DSM IIIR - dementia, IQ-CODE, 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4‡
(detail)		 Zandi, 2002
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "APOE4" (APOE e4 genotype), "MMSE" (baseline MMSE), "FUT" (follow up time), "RE" (race/ethnicity)
 
Table 12:   Use of aspirin (current vs. not using)
Notes These reports examined aspirin use at baseline in relation to Alzheimer disease (AD) risk. Aspirin was also referred to as Acetylsalicylic acid-containing medications or salicylates. Unless otherwise specified, the reference groups consisted of persons not using aspirin at baseline.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
Arvanitakis, 2008 ROS Incidence study reporting hazard ratios (HRs) 1019
(69%)		 -
(detail)
Baseline use
Not using: 62%
Current use: 38%
(detail)
134
75
Total: 209
1.00
0.84
Ref.
0.63-1.11
Ref.
0.23
*
 
 
 
 
 		 Caucasian
(detail)		 75 (-)
( - )		 Screening: CERAD, Neuropsych Testing

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G‡
(detail)		 Arvanitakis, 2008
Cornelius, 2004 Kungsholmen Project Incidence study reporting hazard ratios (HRs) 1301
(75%)		 4.1 y
*
Baseline use
Not using: 89%
Current use: 11%
(detail)
-
-
Total: 257
1.00
1.34
Ref.
0.96-1.89
Ref.
0.09
*
301
49
Total: 350
1.00
1.13
Ref.
0.83-1.53
Ref.
0.43
*		 Swedish
(detail)		 - (-)
( - ≥ 75)
(detail)		 Screening: MMSE

AD Diagnosis: DSM IIIR, Hachinski's Ischemic Scale (Hachinski, 1975)
(detail)		 A, E, G‡
(detail)		 Cornelius, 2004
Côté, 2012 CSHA Incidence study reporting hazard ratios (HRs) 4916
(61%)		 10 y
(detail)
Baseline use of ASA without barbiturates
Not using NSAIDs: 56%
Current use: 44%
(detail)
259
176
Total: 435
1.00
0.87
Ref.
0.58-1.30
Ref.
0.5
*
375
255
Total: 630
1.00
0.74
Ref.
0.54-1.01
Ref.
0.06
*		 Other
(detail)		 76 (7)
( - ≥ 65)
(detail)		 Screening: 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, ALC, AOS, CVRF, CI, MG, OA, PA, SM‡
(detail)		 Côté, 2012
Côté, 2012 CSHA Incidence study reporting hazard ratios (HRs) 4916
(61%)		 10 y
(detail)
Baseline use of ASA with barbiturates
Not using NSAIDs: 79%
Current use: 21%
(detail)
357
78
Total: 435
1.00
0.83
Ref.
0.64-1.06
Ref.
0.15
*
495
135
Total: 630
1.00
1.03
Ref.
0.85-1.25
Ref.
0.76
*		 Other
(detail)		 76 (7)
( - ≥ 65)
(detail)		 Screening: 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, ALC, AOS, CVRF, CI, MG, OA, PA, SM‡
(detail)		 Côté, 2012
Lindsay, 2002 CSHA Cumulative incidence study reporting odds ratios (ORs) 3238
(61%)		 -
(detail)
Baseline use
Not using: 75%
Current use: 25%
(detail)
122
30
Total: 152
1.00
0.85
Ref.
0.55-1.31
Ref.
0.46
*
 
 
 
 
 		 Caucasian
(detail)		 73 (-)
( - ≥ 65)		 Screening: 3MSE

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, E, G‡
(detail)		 Lindsay, 2002
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "ALC" (alcohol intake), "AOS" (antioxidative Supplements), "CVRF" (cardiovascular risk factors), "CI" (comorbidity index), "MG" (Migraine), "OA" (Osteoarthritis), "PA" (physical activity), "SM" (smoking status)
 
Table 13:   Use of aspirin by duration
Notes These reports examined aspirin use in relation to Alzheimer disease (AD) risk. Some reports evaluated use at baseline, whereas others incorporated updates to NSAID use after baseline (also called time-updated use) and effectively evaluated use at the time of the diagnostic assessment or 2 years prior (also called lag). Aspirin was also referred to as Acetylsalicylic acid-containing medications or salicylates. Reported estimates compared AD risk by duration of aspirin use, modeled as a categorical variable.  
  Alzheimer Disease Total Dementia  
Paper Cohort Study Type # Subjects
(% Female)		 Average Follow-up Time Exposure Distribution
# of Cases Effect Size 95% CI P-value # of Cases Effect Size 95% CI P-value Ethnicity Age at Start of Follow-up:
Mean (SD)
(Range)		 Diagnostic Assessment Covariates & Analysis Comment Paper
In 'T Veld, 2001 Rotterdam Study Incidence study reporting hazard ratios (HRs) 6989
(60%)		 6.8 y
(detail)
Cumulative use at time of AD evaluation
Non-use: 67%
Short-term use: 4%
Intermediate-term use: 15%
Long-term use: 14%
(detail)
-
-
-
-
Total: 293
1.00
0.76
1.30
0.76
Ref.
0.31-1.84
0.97-1.74
0.49-1.19
Ref.
0.55
0.08
0.23
*
 
 
 
 
 
 
 		 Dutch
(detail)		 - (-)
( - ≥ 55)
(detail)		 Screening: Brain Imaging, CAMDEX, GMS, MMSE, Neuropsych Testing

AD Diagnosis: DSM IIIR, NINDS-AIREN, NINCDS ADRDA
(detail)		 A, E, G, AHD, H2A, HGU, SM‡
(detail)		 In 'T Veld, 2001
Stewart, 1997 BLSA Incidence study reporting hazard ratios (HRs) 1686
(42%)		 8.0 y
*
(detail)
Use at time of AD evaluation
Never used:         
<2 years:         
2+ years:         
(detail)
-
-
-
Total: 81
1.00
0.74
0.85
Ref.
0.36-1.51
0.53-1.37
Ref.
0.41
0.5
*
 
 
 
 
 
 		 Caucasian
 - (-)
( - )
(detail)		 Screening: Blessed, MMSE, Pfeffer FAQ, TMT

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, G, FUT‡
(detail)		 Stewart, 1997
Stewart, 1997 BLSA Incidence study reporting hazard ratios (HRs) 1686
(42%)		 8.0 y
*
(detail)
Use 2 y prior to AD evaluation
Never used:         
<2 years:         
2+ years:         
(detail)
-
-
-
Total: 81
1.00
0.58
0.82
Ref.
0.28-1.18
0.50-1.36
Ref.
0.14
0.44
*
 
 
 
 
 
 		 Caucasian
 - (-)
( - )
(detail)		 Screening: Blessed, MMSE, Pfeffer FAQ, TMT

AD Diagnosis: DSM IIIR, NINCDS ADRDA
(detail)		 A, G, FUT‡
(detail)		 Stewart, 1997
Zandi, 2002 Cache County Study Incidence study reporting hazard ratios (HRs) 3227
(-)		 3.1 y
*
Baseline use
Never used: 61%
≤2 years:         
>2 years:         
(detail)
64
-
-
Total: 101
1.00
-
0.57
Ref.
-
0.31-0.99
Ref.
-
0.06
*
 
 
 
 
 
 		 Caucasian
(detail)		 74 (6)
( - ≥ 65)
(detail)		 Screening: DQ, DSM IIIR - dementia, IQ-CODE, 3MSE

AD Diagnosis: NINCDS ADRDA
(detail)		 A, E, G, APOE4‡
(detail)		 Zandi, 2002
* Derived value.
 ‡ Covariates: "A" (age), "E" (education), "G" (gender), "AHD" (antihypertensive drug use), "APOE4" (APOE e4 genotype), "FUT" (follow up time), "H2A" (histamine H-2 receptor antagonists use), "HGU" (hypoglycemic drug use), "SM" (smoking status)