Ibuprophen has been shown to be theraputic in the prevention of
Alzheimer's.  However, Ibuprophen can cause kidney damage when used to
treat arthritis.  Is there a theraputic dosage for Alzheimer's that is
harmless to the kidneys?

Charliet33,

I found one study that indicated the benefits of NSAIDs (nonsteroidal
antiinflammatory drugs) on Alzheimer's Disease could be found with
dosages as low as 1 per day, whereas a second study's results suggest
that kidney damage can occur with regular doses of about 3 pills per
day for 6 years.

"In long-term users of NSAIDs, the protective effect appeared to be
the same whether people had taken low doses (one "daily dose" or less,
as defined by Dutch prescribing rules) or higher doses."

http://detnews.com/2001/health/0111/26/health-349547.htm

"The ingestion may have been excessive, with as much as 2 or more kg
(4 - 5 pounds) total medication ingested over a period of years, or
about 3 pills per day for 6 years."

http://www.nlm.nih.gov/medlineplus/ency/article/000482.htm


Additionally, in one study, the ibuprofen dosage was listed as
800mg/day.  However, according to several other concurrent studies,
the dosage of ibuprofen and other NSAIDs may be less important to
lowering Alzheimer's risk than the length of time you have been taking
it.  One study indicates that you must take an NSAID regularly for 2
years before the onset of any symptoms for the drug therapy to have
any effect on the progression of the disease.

"However, the duration of medication with NSAIDs was found to be very
important. With less than one month's use and with 1 - 24 months' use,
the likelihood of developing Alzheimer's was 95% and 83%,
respectively. Again, these findings were not statistically
significant. But, for those taking an NSAID for 24 months or longer,
the likelihood of developing Alzheimer's was only 20% of that for
non-users.

Put another way: the chances of getting Alzheimer's disease in the
8-year period was 8.2% in non-users of NSAIDs, compared with 1.3% in
those taking NSAIDs for at least two years."

http://www.healthandage.org/Home/gid2=1671

"Only the duration of NSAID use, not the daily dose, was associated
with a reduction in risk. In people who had taken such a drug for less
than two years, the frequency of the disease was not significantly
different from that of nonusers, but risk declined steadily with
increasing duration of use."

http://detnews.com/2001/health/0111/26/health-349547.htm

This research was performed because of 20 population studies
suggesting that anti-inflammatory drugs may reduce AD risk from 60
percent and 75 percent. In these studies, the average ibuprofen dose
was about 800 milligrams per day. However, anyone now choosing to use
over the counter anti-inflammatory drugs chronically should consult
their physicians about potential side effects.

http://www.eurekalert.org/pub_releases/2000-07/SfN-Iraf-2707100.php


The kidney disease that is a danger from long-term NSAID usage is
called analgesic nephropathy.  Analgesic nephropathy is tied to the
dosage of NSAIDs, but also to other pre-existing risk factors.

"A different kind of problem can result from taking painkillers every
day for several years. Analgesic nephropathy is a chronic kidney
disease that gradually leads to end-stage renal disease and the
permanent need for dialysis or a kidney transplant to restore renal
function."

http://www.intelihealth.com/IH/ihtIH/WSIHW000/23847/23851/273415.html?d=dmtContent

"Analgesic nephropathy is a chronic kidney disease that gradually
leads to end-stage renal disease and the need for permanent dialysis
or a kidney transplant to restore renal function. It can result from
taking painkillers every day for several years. And, the painkillers
that combine two or more analgesics (for example, aspirin and
acetaminophen together) with caffeine or codeine are the most likely
to damage the kidneys. These
mixtures are often sold as powders. Analgesic nephropathy occurs in
four out of 100,000
people, usually in women over 30 years of age."

http://www.methodisthealth.com/urogen/analge.htm

"Analgesic nephropathy is one type of toxic injury to the kidney. It
is usually a result of prolonged or chronic ingestion of analgesics,
especially OTC medications that contain phenacetin or acetaminophen -
oral and nonsteroidal antiinflammatory drugs (NSAIDs) including
aspirin or ibuprofen.

Analgesic nephropathy occurs in about 4 out of 100,000 people, mostly
women over 30 years old. The incidence has decreased significantly
since phenacetin is no longer widely available in OTC preparations.
Risk factors include use of OTC analgesics containing more than one
active ingredient, chronic headache, chronic backache or
musculoskeletal pain, pain with menstrual periods, emotional and/or
behavioral changes, and history of dependent behaviors including
smoking, alcoholism, and excessive use of tranquilizers. There may
also have been a history of previous urinary tract infection (see UTI
- acute), interstitial nephritis, renal calculi, prerenal azotemia,
congestive heart failure, or blood volume depletion (such as
dehydration)."

http://www.nlm.nih.gov/medlineplus/ency/article/000482.htm


The method by which ibuprofen and NSAIDs are thought to affect
Alzheimer's disease is explained in the following article:

"According to Kawas, 'many scientists now believe that inflammation
may be an important component of the Alzheimer’s disease process. The
amyloid and protein plaques found in Alzheimer’s patient’s brains,
which are hallmarks of the disease, may be indicative of an
inflammatory response.' Researchers believe that NSAIDs may influence
inflammation by interfering with the actions of some proteins and thus
lessening their harmful effects."

http://www.nia.nih.gov/news/pr/1997/03%2D10.htm


One thing that all the sites I saw did agree on was that if a person
is going to take NSAIDs regularly over a long period of time for any
reason, they should be under the care of a doctor.   Further, doctors
and researchers warn that clinical trials are needed before ibuprofen
should be used as a treatment option for Alzheimer's.
  
"Scientists advise against taking NSAIDs to prevent AD based on these
results alone. The BLSA survey identified only an association of NSAID
use with a decreased prevalence of AD, and did not establish any
causal relationship or protective effect of these drugs. NSAIDs have
potentially serious side effects, including stomach irritation and
ulcers. Further research is needed to determine whether NSAIDs
decrease a person's risk of developing AD. As with estrogen, the only
way to prove a cause and effect relationship is through clinical
trials. Until such clinical trials are performed and the results
carefully evaluated, taking NSAIDs to preserve cognitive function is
not advised."

http://www.alzheimers.org/pr98.html


Regards,
Cindy


Some relevant URLs:

University of Maryland: More information about analgesic nephropathy
http://www.umm.edu/urology-info/analge.htm

Intelihealth: Kidney Disease
http://www.intelihealth.com/IH/ihtIH/WSIHW000/23847/23847.html

WebMD: Report on recent research regarding Alzheimer's and Ibuprofen
http://my.webmd.com/content/article/1728.60286

University of Tennessee Medical Center: Guide to Pain Relievers
http://www.utmck.edu/Neurology/pain_relievers.asp


Search terms used:

ibuprofen OR NSAID "kidney damage" arthritis alzheimer's
://www.google.com/search?hl=en&q=ibuprofen+OR+NSAID+%22kidney+damage%22+arthritis+alzheimer%27s

"Analgesic nephropathy"
://www.google.com/search?hl=en&q=%22Analgesic+nephropathy%22

ibuprofen OR NSAID "kidney disease" dose OR dosage
://www.google.com/search?hl=en&q=ibuprofen+OR+NSAID+%22kidney+disease%22+dose+OR+dosage

"national institute on aging" ibuprofen kidney
://www.google.com/search?hl=en&q=%22national+institute+on+aging%22+ibuprofen+kidney

Hi Charliet,

You may also wish to investigate what studies are being done on the
herbal front with phosphatidylserine, pyritinol, and euleuthrococcus
root for treatment of Alzheimer's.

Here are a few links to get you started.


http://www.thorne.com/altmedrev/phos4-2.html

http://www.therubins.com/aging/alzheim4.htm

http://www.therubins.com/alzheim/alzno18.htm

Peace,
V

The benefits of NSAIDS is thought to be via their inhibition of
Cyclooxygenase (COX) -I would like to mention that omega 3 fatty acids
compete for the COX binding site and inhibit proinflammatory
(arachidonic acid metabolites) prostaglandin production.

Here is an abstract (basically stating that low omega 3 fatty acid
levels may be a harbinger of AD):

Lipids  2000 Dec;35(12):1305-12 
Fatty acid analysis of blood plasma of patients with Alzheimer's
disease, other
types of dementia, and cognitive impairment.
Conquer JA, Tierney MC, Zecevic J, Bettger WJ, Fisher RH.

Department of Human Biology and Nutritional Sciences, University of
Guelph,
Ontario, Canada. jconquer@uoguelph.ca

Fatty acid differences, including docosahexaenoic acid (DHA; 22:6n-3)
have been
shown in the brains of Alzheimer's patients (AD) as compared with
normal
age-matched individuals. Furthermore, low serum DHA is a significant
risk factor
for the development of AD. The relative concentration of DHA and other
fatty
acids, however, in the plasma of AD patients compared with patients
with other
kinds of dementias (other dementias; OD), patients who are cognitively
impaired
but nondemented (CIND), or normal patients is not known. In this study
we
analyzed the total phospholipid, phosphatidylcholine (PC),
phosphatidylethanolamine (PE), and lysophosphatidylcholine (lysoPC)
fractions of
plasma from patients diagnosed with AD, OD, or CIND and compared them
with a
group of elderly control subjects with normal cognitive functioning.
Plasma
phospholipid and PC levels of 20:5n-3, DHA, total n-3 fatty acids, and
the
n-3/n-6 ratio were lower in the AD, OD, and CIND groups. Plasma
phospholipid
24:0 was lower in the AD, OD, and CIND groups as compared with the
group of
control patients, and total n-6 fatty acid levels were higher in the
AD and CIND
groups only. In the plasma PE fraction, levels of 20:5n-3, DHA, and
the total
n-3 fatty acid levels were significantly lower in the AD, OD, and CIND
groups.
DHA levels were lower in the lysoPC fraction of CIND individuals only.
There
were no other differences in the fatty acid compositions of the
different
phospholipid fractions. Therefore, in AD, OD, and CIND individuals,
low levels
of n-3 fatty acids in the plasma may be a risk factor for cognitive
impairment
and/or dementia. Interestingly, a decreased level of plasma DHA was
not limited
to the AD patients but appears to be common in cognitive impairment
with aging.