ArticleBMJ open2020
Central nervous system (CNS) medications and polypharmacy in later life: cross-sectional analysis of the English Longitudinal Study of Ageing (ELSA).
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis.BMC geriatrics · 2023Pooled it
- Central Nervous System-Active Medications and Risk of Hospital Readmission in Older Multimorbid Adults.Journal of the American Geriatrics Society · 2025Trial
- CNS-active medication use and adverse health outcomes among Thai older adults: a population-based retrospective study.Scientific reports · 2026Article
- Prevalence of central nervous system-active polypharmacy in a cohort of older adults in Argentina.BJPsych open · 2024Article
- Polypharmacy in atrial fibrillation: A prospective analysis of mortality and ischemic stroke using the Clinical Practice Research Datalink.Journal of arrhythmia · 2024Article
- Drugs utilization profile in England and Wales in the past 15 years: a secular trend analysis.BMC primary care · 2022Article
- The patterns and implications of potentially suboptimal medicine regimens among older adults: a narrative review.Therapeutic advances in drug safety · 2022Review
- An Update on Medication Use in Older Adults: a Narrative Review.Current epidemiology reports · 2021Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMany central nervous system (CNS) medications are considered potentially inappropriate for prescribing in older people; however, these medications are common in polypharmacy (≥5 medicines) regimens. This paper aims to determine the prevalence of CNS drug classes commonly taken by older people. Furthermore, this paper aims to determine whether polypharmacy and other factors, previously found to be associated with overall polypharmacy, are associated with the most common CNS drug classes.
designCross-sectional study.
settingEnglish Longitudinal Study of Ageing (wave 6).
participants7730 participants (≥50 years).
main outcome measuresAdjusted Odds Ratios (OR) and 95% confidence intervals (CI) for CNS drug classes.
results31% of the sample were currently taking ≥5 medications (polypharmacy), of whom 58% (n=1362/2356) were taking CNS medicines as part of their regimen. The most common CNS drug classes in polypharmacy regimens were non-opioid analgesics, opioid analgesics, tricyclic and related antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) (34.6%, 13.2%, 10.9% and 10.4%, respectively). Compared with people currently taking 1-4 prescribed medicines, polypharmacy was associated with adjusted ORs of 5.71 (95% CI: 4.29 to 7.61, p<0.01) for opioid analgesics, 3.80 (95% CI: 3.25 to 4.44, p<0.01) for non-opioid analgesics, 3.11 (95% CI: 2.43 to 3.98, p<0.01) for TCAs and 2.30 (95% CI: 1.83 to 2.89, p<0.01) for SSRIs. Lower wealth was also associated with the aforementioned CNS drug classes.
conclusionOpioid and non-opioid analgesics were the most prevalent classes of CNS medicines in this study. Polypharmacy is strongly associated with the aforementioned classes of analgesics. Polypharmacy is also associated with TCAs and SSRIs, although to a lesser extent than for analgesics. For all CNS medicine classes, polypharmacy may need to be considered in relation to reducing the risk of potential adverse events. After adjustment, lower wealth is associated particularly with analgesics, highlighting that socioeconomic factors may play a role in the prescribing of CNS medicines. These findings provide a baseline for future research into this area.
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