Effect of NSAIDs on risk of Alzheimer's disease: Confounding factors were not discussed

doi:10.1136/bmj.327.7417.751-b

BMJ 2003;327:751 (27 September), doi:10.1136/bmj.327.7417.751-b

Letter

Effect of NSAIDs on risk of Alzheimer's disease

Confounding factors were not discussed

The first 150 words of the full text of this article appear below.

EDITOR—In their study of the effect of non-steroidal anti-inflammatorydrugs (NSAIDs) Etminan et al did not consider possible confoundingfactors for what is currently only an observed reduction inrisk.¹

What if having osteoarthritis is negatively associated withdeveloping Alzheimer's disease? Presumably some form of osteoarthritisis the likely reason why older people are receiving NSAIDs.Both conditions have genetic and environmental components thatmay well be mutually exclusive.

That NSAIDs offer some protection against the development ofAlzheimer's disease cannot yet be stated with confidence. AsDavey Smith and Ebrahim pointed out in an editorial, an associationdoes not show causation, and doctors have been caught out givingpoorly based and premature advice (and treatment) before.²

A recently published randomised controlled trial did not showany benefit from either naproxen or rofecoxib in preventingthe progression of early Alzheimer's disease.³ We may be nofurther forward in . . . [Full text of this article]

Michael Robertson, general practitioner

Marcham Road Health Centre, Abingdon, Oxfordshire OX14 1DB michael.robertson@gp-k84041.nhs.uk

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