Use of CDR-sob and ADAS-cog score to check protective role of Non-steroidal AntiInflammatory Drugs in Alzheimer Disease: A Systematic Review and Meta-Analysis

ABSTRACT

Background Alzheimer’s disease is the major neurodegenerative disease, affecting more than two third cases of dementia in the world. NSAIDs are widely used anti-inflammatory analgesic agents representing 7.7% of worldwide prescription of which 90% are in patients over 65 year old. Based on mixed findings by different RCTs, a systematic review and meta-analysis on CDR-sob and ADAS-cog score was conducted to develop the better understanding on the protective role of Non-steroidal anti inflammatory drugs (NSAIDs) in AD. Methods Data base search was Pubmed, WebScience and Embase. RCTs investigating the effect of NSAIDs on AD or test scores assessing cognitive function in people without AD at baseline were included. Two indicators ADAS-cog score, and CDR-sob are used. Total 09 studies are included in the present Metaanalysis. Results For ADAS-score pooled the pooled summary effect size was calculated using random effect model was -0.03 with 95% C.I -0.13 to 0.07, which was statistically insignificant (p-value =0.44). For CDRsob score difference, the pooled the pooled summary effect size was calculated using random effect model was -0.09 with 95% C.I -0.29 to 0.11 which was statistically insignificant (p=0.3812).For CDR-sob score, the pooled summary effect size was calculated using random effect model was 0.21 with 95% C.I -0.09 to 0.51, which was statistically insignificant (p-value = 0.1741). Conclusion Present Meta analysis shows that NSAIDs in general are not effective in treatment of AD. They also have no protective effect against development of AD on their sustained use.