Warding off Alzheimer's with Ibuprofen

The painkiller may turn out to be the one of the best tools to prevent Alzheimer's. But consistent use of ibuprofen can cause physical problems. What to do? Madeleine Brand speaks with medical contributor Dr. Sydney Spiesel.

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MADELEINE BRAND, host:

There is no cure for Alzheimer's disease, but there may be a way to prevent it with common ibuprofen. An enormous study of 50,000 patients shows that certain anti-inflammatory drugs are probably helpful in delaying or preventing Alzheimer's. That does not mean, though, we should all start popping ibuprofen every day. Dr. Sydney Spiesel is a professor at the Yale Medical School and our medical expert here on Day to Day. Hi, Syd.

Dr. SYDNEY SPIESEL (Professor, Yale Medical School): Hi, Madeleine.

BRAND: Well, tell us more about this study. Who did it and how did they come to their findings? Fifty thousand patients, that's a lot.

Dr. SPIESEL: It was research that was done in the V.A. - the Veterans Administration system. They began by taking patients over a six-year period. They only accepted patients who did not start at the beginning of the six-year period with Alzheimer's disease.

They started tracking sort of everybody identified as developing Alzheimer's disease during this period and at the end of the six years, they had 50,000 patients with Alzheimer's disease, or virtually 50,000. Now, that seems like a huge number but you know, there are about 5 million cases of Alzheimer's in the United States right now and probably about 24 million cases in the world. So, it's a quite common and quite terrible disease.

Each of these 50,000 patients was then matched with four other V.A. patients of the same age, from the same facility, who didn't have Alzheimer's. And they just looked at their pattern of what prescriptions had been written for the people with Alzheimer's and the controll patients. What they were looking particularly were these anti-inflammatory drugs that doctors call NSAIDs, drugs like Advil or Motrin that is ibuprofen, or naproxen, which people know is Aleve. They're often used for arthritis.

BRAND: And they found that the drugs worked?

Dr. SPIESEL: Well, you know, I really hate in this case the word worked. The most I'm prepared to say is that there really was a tremendous difference in usage between these two groups. The patients without Alzheimer's had a much, much greater probability of using ibuprofen, for example, and that was the most effective of all the drugs looked at. And the longer they took it, the lower the risk until finally, the patients who had been taking ibuprofen for the full five years had only half the risk of developing Alzheimer's compared with the patients who had not been taking it.

BRAND: So that would indicate to me that I should go out right now, buy myself a bottle of ibuprofen, and start taking it.

Dr. SPIESEL: Well, no, I wouldn't say so, for a number of reasons. The problem is that drugs in this category are not benign. They can lead to an intense irritation of the lining of the stomach, which can lead to potentially fatal bleeding. Gastrointestinal bleeding is one of the most common outcomes of taking excessive amounts of these drugs over a long period of time. They also neutralize the effect - many patients are taking drugs like baby aspirin for cardiovascular protection. Ibuprofen for example, neutralizes the benefit of this baby aspirin, so that's another issue. For some patients, these drugs can cause risk of severe kidney damage, even kidney failure. So never do this without consulting with your doctor first.

BRAND: Syd, you mentioned that association should not be confused with causation, so I imagine further study will be warranted by this.

Dr. SPIESEL: Absolutely. What we need to do is a study where some patients are given these drugs in a long-term way. Other patients are not given those drugs. Nobody knows - or that is to say, the researchers and the patients don't know who was given the drugs and who wasn't given the drugs, and track these two populations for the development of Alzheimer's disease. That is to say, this is the gold standard in medical testing, the double-blind, random, control trial.

BRAND: Thank you, Syd.

Dr. SPIESEL: Thank you.

BRAND: Dr. Sydney Spiesel is a Yale Medical School professor and a pediatrician, and he's a regular on our program. He comes to us from the online magazine Slate.

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