Older adults who begin taking opioids after a dementia analysis are 11 instances extra more likely to die throughout the first two weeks of taking the medicine, new analysis reveals.
One-third of sufferers with dementia who have been prescribed opioids died inside 180 days of beginning their first opioid prescription, whereas simply 6.4% of the dementia sufferers not uncovered to opioids died inside that time-frame, based on the examine by researchers on the Danish Dementia Research Center in Copenhagen.
The examine, launched Tuesday on the Alzheimer’s Association International Conference in Amsterdam, tracked everybody in Denmark age 65 and older who was recognized with dementia over an 11-year interval ending in December 2018. More than 75,000 folks have been studied, and 42% of them obtained an opioid prescription after their dementia analysis.
Opioids’ identified unwanted effects embrace sedation, confusion, insufficient respiratory and falls, Dr. Christina Jensen-Dahm, a researcher on the Danish dementia heart and lead creator of the examine, stated in an announcement. “Older adults with dementia have a severe brain disorder and are often frail,” Jensen-Dahm stated. “We suspect this is why they cannot tolerate opioids,” though extra analysis is required to know the problem.
The use of “strong opioids,” reminiscent of oxycodone and fentanyl, has elevated significantly in recent times amongst older folks with dementia, Jensen-Dahm stated. Other current research have discovered a rise in opioid prescriptions for older adults with dementia over the previous 20 years or so, whereas prescribing of antipsychotic medicines for these sufferers has tapered off — suggesting that opioids to some extent changed antipsychotics as a way for managing the behavioral signs of dementia, researchers say.
Among greater than 35,000 residents residing with dementia in Veterans Health Administration nursing properties, for instance, antipsychotic prescriptions declined between 2009 and 2018, whereas opioid prescriptions climbed to greater than 41%, from 33%, based on a examine printed final yr within the American Journal of Psychiatry.
Those tendencies coincide with a years-long regulatory effort to rein in the usage of antipsychotic medicines in nursing properties. The U.S. Food and Drug Administration has established black-box warnings associated to make use of of sure antipsychotic medicines in folks with dementia, because of issues about elevated danger of loss of life.
In the Danish examine launched Tuesday, which included folks residing in nursing properties in addition to these residing at residence, robust opioids have been linked with a sixfold improve in danger of loss of life. Among sufferers who used fentanyl patches as their first opioid prescription, 64% died inside 180 days, the researchers discovered.
“Opioids are very powerful drugs, and while we need to see additional research in more diverse populations, these initial findings indicate they may put older adults with dementia at much higher risk of death,” Dr. Nicole Purcell, a neurologist and senior director of medical observe on the Alzheimer’s Association, stated in an announcement. While ache shouldn’t go undiagnosed or untreated, Purcell stated, the analysis underscores the necessity for dialogue between sufferers, households and medical doctors, and cautious monitoring of the affected person.
In up to date opioid prescribing pointers issued late final yr, the Centers for Disease Control and Prevention stated medical doctors ought to take extra steps to reduce the dangers of any opioids prescribed for folks 65 and older, together with danger evaluation for falls and monitoring for cognitive impairment.
Source web site: www.marketwatch.com
