title: Use of CNS medications and cognitive decline in the aged: a longitudinal population-based study.
abstract: BACKGROUND
  Previous studies have found associations between the use of central nervous system medication and the risk of cognitive decline in the aged. Our aim was to assess whether the use of a single central nervous system (CNS) medication and, on the other hand, the combined use of multiple CNS medications over time are related to the risk of cognitive decline in an older (≥ 65 yrs) population that is cognitively intact at baseline.
  
  
  METHODS
  We conducted a longitudinal population-based study of cognitively intact older adults. The participants were 65 years old or older and had Mini-Mental State Examination (MMSE) sum scores of 24 points or higher. The study included a 7.6-year follow-up. The use of benzodiazepines and related drugs (BZDs), antipsychotics (APs), antidepressants (ADs), opioids (Ops), anticholinergics (AChs) and antiepileptics (AEs) was determined at baseline and after a 7.6-years of the follow-up period. Cognitive functioning was used as an outcome variable measured with MMSE at baseline and at the mean follow-up of 7.6 years. Control variables were adjusted with analyses of covariance.
  
  
  RESULTS
  After adjusting for control variables, the use of Ops and the concomitant use of Ops and BZDs as well as the use of Ops and any CNS medication were associated with cognitive decline. The use of AChs was associated with decline in cognitive functioning only in men.
  
  
  CONCLUSIONS
  Of all the CNS medications analyzed in this study, the use of Ops may have the greatest effect on cognitive functioning in the ageing population. Due to small sample sizes these findings cannot be generalized to the unselected ageing population. More studies are needed concerning the long-term use of CNS medications, especially their concomitant use, and their potential cognitive effects.
authors: Department of Family Medicine, University of Turku, Turku, Finland. juhpuu@utu.fi
authors: Juha
authors: J
authors: Puustinen
authors: Janne
authors: J
authors: Nurminen
authors: Minna
authors: M
authors: Löppönen
authors: Tero
authors: T
authors: Vahlberg
authors: Raimo
authors: R
authors: Isoaho
authors: Ismo
authors: I
authors: Räihä
authors: Sirkka-Liisa
authors: SL
authors: Kivelä
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D010054:Brief Psychiatric Rating Scale; D002491:Central Nervous System Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011159:Population Surveillance / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid; D002491:Central Nervous System Agents; D001569:Benzodiazepines