title: Life long changes in cognitive ability are associated with prescribed medications in old age.
abstract: OBJECTIVE
  To determine the association between prescribed medication and life long changes in cognitive ability.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Community residents of a largely urban region of South East Scotland.
  
  
  METHODS
  Four hundred and seventy-eight survivors of the 1932 Scottish Mental Health Survey (n=87,498) without dementia.
  
  
  METHODS
  The Moray House Test (MHT) of intelligence administered at age 11 and age 80 years. Hospital Anxiety and Depression Scale (HADS) score, history of disease and current prescribed medications age 80 years.
  
  
  RESULTS
  After adjusting for sex, neuroactive drugs had a detrimental effect on life long cognitive change age (F=12.2, p=0.001, partial eta-squared=0.026), statins a beneficial effect (F=5.78, p=0.017, partial eta-squared=0.013) and polypharmacy a detrimental effect (F=6.46, p=0.011, partial eta-squared=0.014). In the optimal model estimated marginal means revealed: a relative improvement for statin users, IQ age 11=93.2 (95% CI 87.9-98.4) and age 80=100.6 (95% CI 95.3-105.9); compared with non-users, IQ age 11=100.9 (95% CI 99.4-102.3) and age 80=100.0 (95% CI 98.6-101.5).
  
  
  CONCLUSIONS
  Clinically, the degree to which drugs impair cognition in relatively fit, older people may not be apparent. However, in population terms, medication use, particularly polypharmacy, is important. Statins, used as currently indicated for cardiovascular disease, appear promising in ameliorating cognitive decline in older people. However, firm recommendation of their use should await the outcome of ongoing randomised clinical trials.
authors.affiliation: Geriatric Medicine Unit, University of Edinburgh, Edinburgh, UK. john.starr@ed.ac.uk
authors.forename: John M
authors.initials: JM
authors.lastname: Starr
authors.forename: Brian
authors.initials: B
authors.lastname: McGurn
authors.forename: Martha
authors.initials: M
authors.lastname: Whiteman
authors.forename: Alison
authors.initials: A
authors.lastname: Pattie
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Whalley
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Deary
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003071:Cognition / Q000187:drug effects*; D004358:Drug Therapy; D064420:Drug-Related Side Effects and Adverse Reactions; D004812:Epidemiologic Methods; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D007360:Intelligence / Q000187:drug effects*; D008297:Male; D019338:Polypharmacy; D011569:Psychiatric Status Rating Scales; D014504:Urban Health / Q000706:statistics & numerical data
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors