Pharmacological strategies for prevention of Alzheimer's disease: The epidemiologic evidence

The burden of Alzheimer's disease (AD) will worsen unless effective strategies for its prevention are developed. Evidence suggests that several classes of commonly used medications may delay or prevent the onset of AD. Among the most promising of these are non-steroidal anti-inflammatory drugs (NSAIDs), hormone replacement therapies (HT), and antioxidant vitamins. We have been examining epidemiologic data to assess the feasibility of developing intervention strategies for AD with one or more of these medications. We have found that both NSAIDs and HT may reduce the risk of AD if taken several years prior to the clinical onset of disease. We have also found that vitamins E and C may provide neuro-protection when taken in supplemental doses and in combination. Formal demonstration of the efficacy of these agents will require properly conducted randomized trials. These trials should be designed taking into consideration the relevant findings from the latest observational studies.