TY - JOUR
T1 - Prescription opioids and longitudinal changes in cognitive function in older adults
T2 - A population-based observational study
AU - Warner, Nafisseh S.
AU - Hanson, Andrew C.
AU - Schulte, Phillip J.
AU - Habermann, Elizabeth B.
AU - Warner, David O.
AU - Mielke, Michelle M.
N1 - Funding Information:
Nafisseh S. Warner's research is supported by grant K23 AG070113 from the National Institute on Aging and through the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. The contents of the manuscript are solely the responsibility of the authors and do not represent the official view of the National Institutes of Health.
Funding Information:
Nafisseh S. Warner's research is supported by grant K23 AG070113 from the National Institute on Aging and through the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. The contents of the manuscript are solely the responsibility of the authors and do not represent the official view of the National Institutes of Health.
Publisher Copyright:
© 2022 The American Geriatrics Society.
PY - 2022/12
Y1 - 2022/12
N2 - Background: Opioids are frequently prescribed to alleviate pain in older adults, yet the relationships between prescription opioids and long-term cognitive function are unclear. Methods: In this analysis of the Mayo Clinic Study of Aging, a longitudinal population-based cohort study of older adults with formal neuropsychological testing and cognitive evaluations performed every 15 months, the associations between prescription opioids, global and domain-specific cognitive function, and mild cognitive impairment were evaluated through time-dependent linear mixed effects and Cox proportional hazards models. Results: Four thousand two hundred eighteen participants (51% male) were included with enrollment between 11/1/2004 and 4/1/2019 and median age of 76 (interquartile range 72, 82) years. Two thousand nine hundred seventy-seven subjects (71%) received at least 1 opioid prescription during a median follow-up of 7.5 (5.0, 10.7) years. Overall, there was an estimated 0.096 reduction in the global cognitive Z-score per year, including decreases of 0.050 in memory, 0.080 in language, 0.044 in visual–spatial cognition, and 0.112 in attention. In multivariable analyses, each receipt of an opioid prescription resulted in an additional −0.007 (95% CI −0.009, −0.005) change in global cognitive Z-score (p < 0.001), with significant effects seen in the domains of memory (−0.005, 95% CI −0.007, −0.003; p < 0.001), language (−0.002, 95% CI −0.003, 0.000; p = 0.024) and attention (−0.004, 95% CI −0.006, −0.002; p < 0.001) but not visual–spatial function (0.000, 95% CI −0.001, 0.001; p = 0.897). Opioid prescriptions were associated with incident mild cognitive impairment (MCI) in adjusted analysis (hazard ratio 1.21, 95% CI 1.04, 1.42; p = 0.014). Conclusion: Prescription opioids are associated with small but statistically significant declines in long-term cognitive function in older adults, which may represent effects of opioids or other related factors.
AB - Background: Opioids are frequently prescribed to alleviate pain in older adults, yet the relationships between prescription opioids and long-term cognitive function are unclear. Methods: In this analysis of the Mayo Clinic Study of Aging, a longitudinal population-based cohort study of older adults with formal neuropsychological testing and cognitive evaluations performed every 15 months, the associations between prescription opioids, global and domain-specific cognitive function, and mild cognitive impairment were evaluated through time-dependent linear mixed effects and Cox proportional hazards models. Results: Four thousand two hundred eighteen participants (51% male) were included with enrollment between 11/1/2004 and 4/1/2019 and median age of 76 (interquartile range 72, 82) years. Two thousand nine hundred seventy-seven subjects (71%) received at least 1 opioid prescription during a median follow-up of 7.5 (5.0, 10.7) years. Overall, there was an estimated 0.096 reduction in the global cognitive Z-score per year, including decreases of 0.050 in memory, 0.080 in language, 0.044 in visual–spatial cognition, and 0.112 in attention. In multivariable analyses, each receipt of an opioid prescription resulted in an additional −0.007 (95% CI −0.009, −0.005) change in global cognitive Z-score (p < 0.001), with significant effects seen in the domains of memory (−0.005, 95% CI −0.007, −0.003; p < 0.001), language (−0.002, 95% CI −0.003, 0.000; p = 0.024) and attention (−0.004, 95% CI −0.006, −0.002; p < 0.001) but not visual–spatial function (0.000, 95% CI −0.001, 0.001; p = 0.897). Opioid prescriptions were associated with incident mild cognitive impairment (MCI) in adjusted analysis (hazard ratio 1.21, 95% CI 1.04, 1.42; p = 0.014). Conclusion: Prescription opioids are associated with small but statistically significant declines in long-term cognitive function in older adults, which may represent effects of opioids or other related factors.
KW - cognition
KW - dementia
KW - epidemiology
KW - opioids
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UR - http://www.scopus.com/inward/citedby.url?scp=85138244757&partnerID=8YFLogxK
U2 - 10.1111/jgs.18030
DO - 10.1111/jgs.18030
M3 - Article
C2 - 36117241
AN - SCOPUS:85138244757
SN - 0002-8614
VL - 70
SP - 3526
EP - 3537
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 12
ER -