Opioids used alone or in combination with other medications which act on the central nervous system cause the largest decline in cognitive functioning in older patients.
Researchers in Finland recruited 1,196 people over the age of 65 who were cognitively intact, with MMSE scores of over 23, and followed them over 7.6 years.
Cognitive decline was found in those taking opioids or combinations of opioids with benzodiazepines, antipsychotics, antidepressants, anticholinergics or anti-epileptics. The use of anticholinergics was associated with cognitive decline only in men.
The authors said the findings couldn’t be directly generalised to an unselected ageing population, and that further studies were needed to confirm the association.
Study leader Juha Puustinen, a researcher in family medicine at the University of Turku, Finland, said:‘In our study, the combination of benzodiazopenes or any CNS medication and opioids was related to the risk of cognitive decline,’ said
‘These findings support the idea that the use of a psychotropic medication alone does not inevitably effect cognitive functioning, but combining this kind of a medication with opioids may be harmful.’
BMC Geriatrics2011 online 1 November