Regular acetaminophen use in older adults linked to increased dementia risk; ibuprofen use not

Cognitive impairment is considered one of the biggest health crises of the 21st century and has become the fifth leading cause of death worldwide. Alzheimer's disease is the most common type of cognitive impairment, accounting for about 50%-70% .

Ibuprofen and acetaminophen are widely used in our daily lives as antipyretic and analgesic drugs. Their possible promotion or adverse reactions to chronic diseases are closely related to the public and have important clinical and public health value. Unlike acetaminophen, ibuprofen, as one of the non-steroidal anti-inflammatory drugs, has obvious anti-inflammatory effects. Some previous cell culture and animal experiments have shown that the use of non-steroidal anti-inflammatory drugs may reduce the risk of Alzheimer's disease by reducing brain inflammation; at the same time, some mechanism studies have found that the use of acetaminophen may increase the risk of Alzheimer's disease. However, there has been no large-sample population study to systematically evaluate the effects of long-term use of ibuprofen and acetaminophen on the risk of dementia.

The picture is from the Internet, and the copyright belongs to the original author. Based on the above clinical problems, the National Clinical Research Center for Kidney Diseases of Nanfang Hospital of Southern Medical University has carried out relevant work, and the research results were recently published in the journal General Hospital Psychiatry . The study found that people who frequently use acetaminophen have a significantly increased risk of dementia; while the use of ibuprofen has no significant effect on the risk of dementia . Professor Qin Xianhui of the National Clinical Research Center for Kidney Diseases of Nanfang Hospital of Southern Medical University is the corresponding author of the article, and Dr. Zhang Yuanyuan and Dr. Zhou Chun are co-first authors.

The study included more than 200,000 participants aged 60 years or older from the UK Biobank study who did not have dementia at baseline. The average age of the population was 64 years, of whom 43,541 participants were regular users of acetaminophen and 22,539 were regular users of ibuprofen.

After approximately 12 years of follow-up, 6,407 participants developed all-cause dementia. Compared with participants who did not use acetaminophen, participants who regularly used acetaminophen had a significantly increased risk of all-cause dementia of 18%, a significantly increased risk of Alzheimer's disease of 20%, and a significantly increased risk of vascular dementia of 26%. However, there was no significant association between ibuprofen use and the risk of all-cause dementia, Alzheimer's disease, or vascular dementia.

Further combined analysis of acetaminophen and ibuprofen found that compared with non-users of either, participants who frequently used acetaminophen had a significantly increased risk of all-cause dementia by 15%, and participants who used both acetaminophen and ibuprofen had a significantly increased risk of all-cause dementia by 28%.

In conclusion, the results of this study suggest that regular use of acetaminophen, but not ibuprofen, is associated with an increased risk of dementia in older adults . The current findings highlight the need for greater safety considerations and caution when choosing between acetaminophen or ibuprofen in clinical settings.

Information points:

The picture comes from the Internet, the copyright belongs to the original author

The picture comes from the Internet, the copyright belongs to the original author

References:

Zhang Y, Zhou C, Yang S, Zhang Y, Ye Z, He P, Liu M, Wu Q, Qin X. Association of regular use of ibuprofen and paracetamol, genetic susceptibility, and new-onset dementia in the older population. Gen Hosp Psychiatry. 2023 Aug 18; 84:226-233.

Editor | Zhang Yuanyuan and Xiang Hao

Audit | Qin Xianhui