Prescription opioid use and cognitive function in older adults with chronic pain: A population-based longitudinal cohort study

IF 11.1 1区医学 Q1 CLINICAL NEUROLOGY Alzheimer's & Dementia Pub Date : 2025-02-24 DOI:10.1002/alz.70002

Yu-Jung Jenny Wei, Almut G. Winterstein, Siegfried Schmidt, Roger B. Fillingim, Stephan Schmidt, Michael J. Daniels, Steven T. DeKosky

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Abstract

INTRODUCTION

Whether prescription opioid exposure, duration, and dose are associated with cognitive function remains inconclusive.

METHODS

A longitudinal cohort among 3097 older adults with chronic pain and without dementia was conducted using Health and Retirement Study (HRS) linked to Medicare data from 2006 to 2020. Prescription opioid exposure, cumulative use for ≥ 90 days, and high-dose use (≥ 90 morphine milligram equivalents [MME] daily) were assessed biennially. Memory score and dementia probability were derived from HRS cognitive measures and analyzed using linear mixed-effects models.

RESULTS

Adjusted memory decline and dementia probability were not statistically different between patients with (vs. without) opioid exposure and between patients with cumulative use for ≥ 90 days (vs. < 90 days) but were higher between participants with high-dose opioid use (vs. low-dose) at the end of the follow-up.

DISCUSSION

Prescription opioid exposure and duration were not associated, but high-dose opioid use was associated with greater memory decline and dementia probability.

Highlights

Opioid use versus no use was not related to memory decline and dementia probability.
Long-term opioid use was not related to memory decline and dementia probability.
High-dose opioid use was related to greater memory decline and dementia probability.

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老年慢性疼痛患者处方阿片类药物的使用和认知功能：一项基于人群的纵向队列研究

处方阿片类药物暴露、持续时间和剂量是否与认知功能相关尚无定论。方法：采用健康与退休研究（HRS）对3097名慢性疼痛且无痴呆的老年人进行纵向队列研究，该研究与2006年至2020年的医疗保险数据相关。处方阿片类药物暴露、累计使用≥90天和高剂量使用（每日≥90吗啡毫克当量[MME]）每两年进行一次评估。记忆评分和痴呆概率来自HRS认知测量，并使用线性混合效应模型进行分析。结果：阿片类药物暴露（vs.未暴露）患者和累计使用≥90天的患者之间调整后的记忆衰退和痴呆概率无统计学差异(vs. <；90天)，但在随访结束时，高剂量阿片类药物使用的参与者之间（与低剂量相比）更高。处方阿片类药物暴露与持续时间无关，但大剂量阿片类药物使用与更大的记忆衰退和痴呆概率相关。阿片类药物使用与不使用与记忆衰退和痴呆概率无关。长期使用阿片类药物与记忆力下降和痴呆概率无关。大剂量阿片类药物的使用与更大的记忆衰退和痴呆概率有关。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.