ArticleDementia and geriatric cognitive disorders extra2012
CNS medications as predictors of precipitous cognitive decline in the cognitively disabled aged: a longitudinal population-based study.
Article in Dementia and geriatric cognitive disorders extra, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02545257 (Development of a Coordinated, Community-Based Medication Management Model for Home-Dwelling Aged in Primary Care), which is not on this map. Cited by 13 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Development of a Coordinated, Community-Based Medication Management Model for Home-Dwelling Aged in Primary Care
Who cites it
13 citing papers in PubMed, 29 citations in OpenAlex.
- Enhanced coordination of care to reduce medication risks in older home care clients in primary care: a randomized controlled trial.BMC geriatrics · 2019Trial
- Limited health literacy and decline in executive function in older adults.Journal of health communication · 2013Trial
- Benzodiazepine-Related Cognitive Impairment or Dementia: A Signal Detection Study Using a Case/Non-Case Approach.Psychiatry investigation · 2020Article
- Anticholinergics and benzodiazepines on cognitive impairment among elderly with Alzheimer's disease: a 1 year follow-up study.BMC research notes · 2020Article
- Development of a Brazilian anticholinergic activity drug scale.Einstein (Sao Paulo, Brazil) · 2019Article
- Drug use differs by care level. A cross-sectional comparison between older people living at home or in a nursing home in Oslo, Norway.BMC geriatrics · 2019Observational
- High prevalence of prescription of psychotropic drugs for older patients in a general hospital.BMC pharmacology & toxicology · 2017Article
- Persistent use of psychotropic drugs in nursing home residents in Norway.BMC geriatrics · 2017Article
- The association between benzodiazepine use and sleep quality in residential aged care facilities: a cross-sectional study.BMC geriatrics · 2016Article
- Older Adults' Perspectives on Clinical Research: A Focus Group and Survey Study.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2016Article
- Review
- Influence of central nervous system-acting drugs on results of cognitive testing in geriatric inpatients.Zeitschrift fur Gerontologie und Geriatrie · 2014Article
- Effect of withdrawal from long-term use of temazepam, zopiclone or zolpidem as hypnotic agents on cognition in older adults.European journal of clinical pharmacology · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsPsychotropics and antiepileptics (AE) are medications commonly used among the aged with cognitive decline or dementia, although they may precipitate further cognitive decline. Our aim was to analyze the relationships between the use of (i) psychotropics (i.e. benzodiazepines or related drugs, BZD, antipsychotics, AP, or antidepressants, AD), opioids (Op), anticholinergics (ACh) or AEs or the concomitant use of two of these drugs, and (ii) the risk of precipitous cognitive decline in an older (≥65 years) cognitively disabled population.
methodsA longitudinal population-based study of general aged community-dwelling patients was executed in two phases (1990-1991 and 1998-1999) in Lieto, Finland. Fifty-two individuals cognitively disabled (MMSE score 0-23) at the 1990-1991 baseline form this study's sample. Cognitive abilities were assessed in each phase with the Mini-Mental State Examination (MMSE) and medication utilization data were collected in both phases. The mean follow-up time was 7.6 years. Multivariate models were used to analyze the change in MMSE total score between medication users and non-users.
resultsBZD or any psychotropic use was associated with greater cognitive decline in elders aged ≥75 years compared to non-users (change in MMSE sum score: -8.6 ± 7.0 vs. -3.3 ± 5.6 and -5.9 ± 7.0 vs. -2.7 ± 6.4, respectively). A greater decline was also associated specifically with the concomitant use of BZD and AP (-16 vs. -1.4 ± 7.8); as were BZD and any drug with CNS effects (-9.6 ± 9.9 vs. -1.3 ± 7.2) compared to non-users. The concomitant use of BZD and AD (-10.7 ± 4.7 vs. -3.2 ± 5.6) or ACh (-15.0 ± 8.5 vs. -3.3 ± 5.6) or any drug with CNS effects (-13.3 ± 6.5 vs. -3.3 ± 5.6) was associated with cognitive decline in patients ≥75 years compared to non-users of any drug with CNS effects.
conclusionThe use of a BZD or any psychotropic medication may be an independent risk factor for cognitive decline in the cognitively disabled aged, and patients co-prescribed psychotropic medications had greater cognitive decline. Studies with larger sample sizes and studies on possible pathophysiologic mechanisms are needed.
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