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Middle-age and elderly people who took anti-inflammatory drugs like ibuprofen or naproxen for at least two years were apparently protected from Alzheimer's disease, according to a new study by scientists in the Netherlands. Their likelihood of getting Alzheimer's dementia was one- sixth that of people who did not take the drugs.

The study, published today in The New England Journal of Medicine, offers hope for preventing Alzheimer's but falls short of being definitive, experts said. They cautioned that the findings did not mean that people should dose themselves with anti- inflammatories, which can have serious side effects, to prevent Alzheimer's.

The researchers, led by Dr. Bruno H. C. Stricker of the Erasmus Medical Center in Rotterdam, invited every person 55 or older in a suburb of Rotterdam, Ommoord, to participate in their study. Of 10,275 who were asked, 6,989 agreed and were eligible. None had Alzheimer's. But by the end of the study, 293 had developed it.

Some participants took anti-inflammatories and some did not, by their own choice and not the researchers' design. Most who took the drugs used them for arthritis.

In the group that took no anti- inflammatory drugs, 210 out of 2,553 developed dementia. But 3 out of 233 who had taken the drugs for at least two years developed it. The dose did not appear to be important, the researchers found.

The effect was specific for Alzheimer's. The drugs did not help other diseases like ministrokes, which can cause memory loss and confusion.

The sole drugs that seemed to affect the risk of Alzheimer's were anti-inflammatories. Aspirin, unlike other anti-inflammatory drugs, did not appear to have a protective effect, possibly, the researchers said, because participants were taking very low doses.

Dr. John Breitner, an Alzheimer's disease researcher at the Johns Hopkins Bloomberg School of Public Health, said the new study was impressive. Unlike many others, it followed healthy people for a long time, an average of 6.8 years, to see who came down with Alzheimer's disease. The investigators also had impeccable records of the patients' use of medicines.

"It's a fantastic study, and they showed a very powerful effect," said Dr. Breitner, who is directing a study of anti-inflammatory drugs in people at risk of becoming ill with Alzheimer's.

A potential flaw in the Dutch study is that the scientists did not randomly assign people to take active drugs or dummy pills for comparison purposes. For that reason, they cannot be certain it was the drugs and not some other characteristic of the patients that made the difference.

Because the drugs have side effects like serious, sometimes fatal, stomach bleeding, medical experts advise healthy people to await the results of randomized trials now under way before taking anti-inflammatory drugs other than aspirin in the hope of preventing Alzheimer's.

A strength of the study is that the researchers had highly reliable information about what drugs the participants took, because for most of the study period nonsteroidal anti- inflammatory drugs were available in the Netherlands only by prescription, and the Dutch keep excellent records on the use of prescription drugs.

By contrast, in earlier studies, researchers had no good way of knowing what drugs people had taken. Some studies with patients suggested that anti-inflammatories prevented Alzheimer's, whereas others did not.

Studies in the laboratory and in animals had also suggested that anti- inflammatory drugs prevented Alzheimer's disease or delayed its onset.

Alzheimer's disease experts say that clinical trials that may confirm or refute the Dutch study will be completed soon.

In one study supported by the National Institute on Aging, people who already have Alzheimer's disease are taking either dummy pills or anti-inflammatory drugs to see whether the drugs can slow the progression of the disease. The researchers will have an answer by the middle of 2002, said Dr. Neil Buckholtz, chief of the Dementias of Aging branch at the institute.

Another study, also supported by the institute, involves healthy people 70 or older with family histories of Alzheimer's. Those subjects, too, are taking anti-inflammatories or dummy pills. That study will take at least five more years, Dr. Buckholtz said.

For now, said Dr. Steven DeKosky, who directs the Alzheimer's Disease Research Center at the University of Pittsburgh, the Dutch study is encouraging.

"This is solid circumstantial evidence," Dr. DeKosky said. "It is probably the strongest evidence so far that anti-inflammatory drugs can quiet things down perhaps enough to delay the onset of the disorder.

"Now it's up to the clinical trials to show us whether or not they are an effective prevention or an effective treatment strategy."