According to a population-based observational study, the use of prescription opioids could negatively impact cognitive function in older individuals. The study made use of the Mayo Clinic Study of Aging’s data, which examined the cognitive decline in older individuals for almost 20 years.
DOI: 10.1111/jgs.18030
The study observed that 70% of individuals received at a minimum 1 opioid prescription over 7.5 years on average. Each prescription was associated with cognitive performance decline, especially in attention, language, and memory. Individuals taking opioids had a 20% higher likelihood of mild cognitive impairment as well, which is a state of cognitive decline exceeding normal aging.
Pain is regarded as common in older individuals, with over half of those 65 or older suffering from pain on the majority of days. The researchers indicate that when considering using prescription opioids in older individuals, treatment should be customized to each individual through evaluation of benefits and risks and careful follow-up.
The study results could result in the development of more efficient strategies for treating pain in older individuals and help in mitigating the negative effect that prescription opioids have on cognitive function.
The researchers point out that the mechanisms aren’t fully understood by which opioids could result in cognitive decline. The important question is if causal relationships between prescription opioid use and cognitive decline are observed, or if prescription opioids are an indicator for other disorders linked to cognitive dysfunction.
This data, although compelling, doesn’t confirm a causal association between prescription opioids and cognitive decline. A clear link however does exist between opioid use and long-term cognitive decline, to be taken into account when deciding whether to prescribe an older individual an opioid.
As opioid prescribing trends for individuals have changed significantly in the past few years, future longitudinal studies are required to evaluate the broader view of the results of this study, evaluate socioeconomic and geographic disparities in the availability of prescription opioids, and examine the mechanisms underlying opioid availability and long-term cognitive function association in older individuals.
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