Prolonged opioid exposure can mess up cognition in seniors

Persistent use of opioids for pain management in older adults may adversely affect their cognitive function, a study has found.

The analysis involved 2,222 individuals aged 65–69 years at baseline from the prospective Personality and Total Health Through Life Study in Australia. Their medication data were drawn from the Pharmaceutical Benefits Scheme.

Exposure to opioids was expressed as Total Morphine Equivalent Dose (MED). All participants underwent a neuropsychological battery assessment to examine cognition. Generalized linear models were used to estimate the association between change in cognitive function between wave 2 and wave 3 and cumulative opioid use.

Results showed that the opioids had a negative effect on cognitive function. Specifically, cumulative exposure exceeding total MED of 2,940 correlated with poorer performance in the Mini Mental State Examination (MMSE).

Compared with those who never used the drugs, individuals exposed to opioids resulting in cumulative total MED of >2,940 had poorer scores in the MMSE (model 1: β, −0.34; model 2: β, −0.35; model 3: β, −0.39; p<0.01).

Opioid use had no impact on performance in other cognitive assessments.

The findings encourage the need for alternative pain management strategies in older adults, emphasizing that the options should not adversely affect healthy ageing trajectories and cognitive health.