Elderly adults who start using opioid painkillers after a dementia diagnosis have a substantially higher risk of death—about 11-fold within the first two weeks, according to new research from Denmark.
The risk of death persisted beyond two weeks, albeit at a lower rate.
Researchers discovered a doubled death risk within 90 days of initiating opioid use and have cautioned doctors to consider the risks versus benefits of opioid use in elderly patients with dementia.
The study, which covered all Danes diagnosed with Alzheimer’s disease over a decade, also found that one-third of patients who started taking opioids died within 180 days of their first dose, compared to about 6% of those in the non-opioid group.
“In our study, starting on an opioid after getting a dementia diagnosis was frequent and associated with a markedly increased risk of death, which is worrisome,” said co-author Dr. Christina Jensen-Dahm of the Danish Dementia Research Centre at Copenhagen University Hospital.
When fentanyl patches were the opioids used, nearly two-thirds of patients died within the first 180 days, compared to approximately 7% of those without opioid prescriptions.
Guidelines from the U.S. Centers for Disease Control and Prevention state that opioid therapy should only be considered for pain if the benefits outweigh the risks, which Jensen-Dahm underscores as “particularly important for older individuals with dementia.”
“Opioids are known to have significant side-effects including sedation, confusion, respiratory depression and falls. Older adults with dementia have a severe brain disorder and are often frail.
We suspect this is why they cannot tolerate opioids, but we need to do more research to answer these questions,” Jensen-Dahm added.
In the study, around 42% of patients diagnosed with dementia between 2008 and 2018 filled a prescription for an opioid. Strong opioids such as morphine and oxycodone were associated with a sixfold increased death risk.
Dr. Nicole Purcell, a neurologist and Alzheimer’s Association senior director, clinical practice, emphasized the need for more research and careful patient monitoring when prescribing pain medication to elderly dementia patients.
If you care about dementia, please read studies about low choline intake linked to higher dementia risk, and how eating nuts can affect your cognitive ability.
For more information about brain health, please see recent studies that blueberry supplements may prevent cognitive decline, and results showing higher magnesium intake could help benefit brain health.
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