Observational studyJournal of the American Geriatrics Society2022
Prescription opioids and longitudinal changes in cognitive function in older adults: A population-based observational study.
Observational study in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Chronic pain and risk of cognitive impairment: a meta-analysis of longitudinal cohort studies.Translational psychiatry · 2026Pooled it
- Impact of paravertebral block on perioperative neurocognitive disorder: a systematic review and meta-analysis of randomized controlled trials.Frontiers in aging neuroscience · 2023Pooled it
- When treatment becomes risk: polypharmacy and inappropriate prescribing in cognitive impairment in 2379 consecutive patients from a memory clinic.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Observational
- Cognition and Depression in American Indian Elders with Prescribed Opioid Use: Data from the Strong Heart Study.Journal of racial and ethnic health disparities · 2026Article
- Aberrant CX3CL1-CX3CR1 Signaling Reprograms Microglial Exosome Secretion via KIFC2 to Drive Cognitive Impairment in Chronic Pain.International journal of molecular sciences · 2026Article
- Korean medicine use is associated with reduced lumbar surgery and opioid prescriptions in lumbar disc herniation: a nationwide cohort study.Frontiers in public health · 2026Article
- Episodic Memory, Chiari I Malformation, Personality and Coping: The Role of Chronic Pain.Behavioral sciences (Basel, Switzerland) · 2025Review
- High-impact pain predicts subjective cognitive decline and interacts with APOE4 genotype in the development of objective cognitive impairment.The journal of pain · 2025Article
- A Qualitative Study of the Effects of Opioids on Chronic Pain, Function, and Cognition in Community-Dwelling Older Adults.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Article
- Repeat Opioid Use Modulates Microglia Activity and Amyloid Beta Clearance in a Mouse Model of Alzheimer's Disease.bioRxiv : the preprint server for biology · 2025Article
- Central Nervous System-Active Medication Use in Older Adults With and Without Dementia-A Retrospective Cohort Study.Journal of general internal medicine · 2025Observational
- Cognitive Function in Patients With Complex Regional Pain Syndrome: No Clear Impairment Found in a Select Patient Sample.European journal of pain (London, England) · 2025Article
- Persistent Opioid Use Following Major Orthopedic Surgery.Current pain and headache reports · 2025Review
- History of chronic pain and opioid use is associated with cognitive decline and mild cognitive impairment.Journal of the International Neuropsychological Society : JINS · 2025Article
- Neurocognitive Functions Among Patients Dependent on Natural Opium: A Comparative Cross-Sectional Study.Cureus · 2025Article
- Regular use of opioids and dementia, cognitive measures, and neuroimaging outcomes among UK Biobank participants with chronic non-cancer pain.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Prescription Opioids and Brain Structure in Community-Dwelling Older Adults.Mayo Clinic proceedings · 2024Article
- Pain, Opioid Analgesics, and Cognition: A Conceptual Framework in Older Adults.Pain medicine (Malden, Mass.) · 2023Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundOpioids are frequently prescribed to alleviate pain in older adults, yet the relationships between prescription opioids and long-term cognitive function are unclear.
methodsIn this analysis of the Mayo Clinic Study of Aging, a longitudinal population-based cohort study of older adults with formal neuropsychological testing and cognitive evaluations performed every 15 months, the associations between prescription opioids, global and domain-specific cognitive function, and mild cognitive impairment were evaluated through time-dependent linear mixed effects and Cox proportional hazards models.
resultsFour thousand two hundred eighteen participants (51% male) were included with enrollment between 11/1/2004 and 4/1/2019 and median age of 76 (interquartile range 72, 82) years. Two thousand nine hundred seventy-seven subjects (71%) received at least 1 opioid prescription during a median follow-up of 7.5 (5.0, 10.7) years. Overall, there was an estimated 0.096 reduction in the global cognitive Z-score per year, including decreases of 0.050 in memory, 0.080 in language, 0.044 in visual-spatial cognition, and 0.112 in attention. In multivariable analyses, each receipt of an opioid prescription resulted in an additional -0.007 (95% CI -0.009, -0.005) change in global cognitive Z-score (p < 0.001), with significant effects seen in the domains of memory (-0.005, 95% CI -0.007, -0.003; p < 0.001), language (-0.002, 95% CI -0.003, 0.000; p = 0.024) and attention (-0.004, 95% CI -0.006, -0.002; p < 0.001) but not visual-spatial function (0.000, 95% CI -0.001, 0.001; p = 0.897). Opioid prescriptions were associated with incident mild cognitive impairment (MCI) in adjusted analysis (hazard ratio 1.21, 95% CI 1.04, 1.42; p = 0.014).
conclusionPrescription opioids are associated with small but statistically significant declines in long-term cognitive function in older adults, which may represent effects of opioids or other related factors.
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Registered trials
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