在老年人中使用中枢神经系统活性药物,有和没有痴呆症 - - 一个回顾性队列研究
Nafisseh S Warner1,2,3, Holly K Van Houten4, Ericka E Tung5
1Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA. warner.nafisseh@mayo.edu.
Journal of general internal medicine
|March 19, 2025
概括
中枢神经系统 (CNS) 活性药物的使用在老年痴呆症患者中较高. 经过痴呆症诊断后,抗抑郁药和抗精神病药物处方的数量显著增加,而阿片类药物和二二类药物的使用量则下降.
科学领域:
- 老年医学 老年医学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 中枢神经系统 (CNS) 活性药物经常被处方给老年人.
- 关于中枢神经系统活性药物使用趋势的数据有限,特别是在痴呆症方面.
- 了解这些趋势对于优化老年护理和药物管理至关重要.
研究的目的:
- 分析13年来美国老年人中中枢神经系统活性药物使用趋势.
- 为了比较痴呆症患者和没有痴呆症患者之间的药物使用情况.
- 检查痴呆症诊断前后药物使用的变化.
主要方法:
- 使用非识别的行政索赔数据进行的回顾性观察队列研究.
- 包括2010年至2022年连续保险覆盖的老年人 (≥65岁) 在内.
- 分析周围痴呆症诊断的年度药物使用概率和药物使用变化.
主要成果:
- 与非痴呆症队列 (88.7%) 相比,痴呆症队列中使用中枢神经系统活性药物的比例始终较高 (11.3%).
- 在这两组中,抗抑郁药的使用增加,而阿片类药物的使用减少.
- 发病性痴呆症诊断与抗精神病药物和抗抑郁药物使用的立即和持续增加以及阿片类药物和二甲类药物使用的减少相关.
结论:
- 患有痴呆症的老年人表现出更高的中枢神经系统活性药物使用率.
- 痴呆症诊断显著影响药物治疗模式,特别是增加抗抑郁药和抗精神病药的使用.
- 这些发现凸显了对认知能力下降的老年人进行谨慎药物管理的必要性.
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