长期疼痛的老年人处方阿片类药物的使用和认知功能:基于人口的纵向队列研究
Yu-Jung Jenny Wei1, Almut G Winterstein2,3,4, Siegfried Schmidt5
1Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, Ohio, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|February 24, 2025
概括
处方阿片类药物的暴露和持续时间不会影响老年人的认知功能. 然而,高剂量的阿片类药物使用与增加记忆力下降和痴呆症风险有关.
科学领域:
- 老年学是一门学科.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 老年人处方阿片类药物使用与认知功能之间的关系尚未得到充分证实.
- 之前的研究已经产生了关于阿片类药物暴露,持续时间和认知衰退的不确定的发现.
研究的目的:
- 调查处方阿片类药物暴露,持续时间,剂量和慢性疼痛的老年人认知功能之间的关联.
- 为了确定累积阿片类药物使用或高剂量阿片类药物使用是否会影响记忆力下降和痴呆症概率.
主要方法:
- 一项对3097名老年人 (2006-2020年) 的纵向队列研究,使用健康和退休研究 (HRS) 和医疗保险数据.
- 处方阿片类药物的暴露,累积使用 (≥90天) 和高剂量使用 (≥90MME/天) 被评估为两年一次.
- 使用线性混合效应模型分析了记忆得分和痴呆症概率.
主要成果:
- 在有或没有阿片类药物暴露的患者之间,没有发现记忆力下降或痴呆症概率的显著差异.
- 超过90天的累积处方阿片类药物使用与认知能力下降无关.
- 高剂量阿片类药物使用 (≥90MME/天) 与更大的记忆力下降和痴呆症概率增加有关.
结论:
- 处方阿片类药物的暴露和持续时间与老年人认知能力下降无关.
- 高剂量的阿片类药物使用是加速记忆力下降和痴呆症概率增加的重要风险因素.
- 在评估患者的认知风险时,临床指南应考虑阿片类药物的剂量.
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