In a prospective study among 4,409 subjects aged 65+ years, we assessed the relation of nonsteroidal anti-inflammatory agents (NSAIDs) to cognition. The main outcome was decline in global cognitive function, determined by average performance across four cognitive tests, over up to four interviews. We found similar rates of cognitive decline among recent users of aspirin and of other NSAIDs (largely ibuprofen) compared to those who did not use these NSAIDs. For lifetime duration of aspirin use, we failed to find an association with cognitive decline. However, for other NSAIDs, increasing duration of lifetime use was related to slower rates of cognitive decline, relative to no use of other NSAIDs (5+ years vs. no use: mean difference = 0.12; p trend = 0.03). Overall, we found no relation between regular aspirin use and cognitive decline, but long-term use of ibuprofen may be related to decreased rates of cognitive decline in older persons.

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