1 Alzheimer's Disease Investigation Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofia Foundation, Alzheimer Research Centre, Madrid, Spain.
2 Service of Neurology, University Hospital Gregorio Marañón, Madrid, Spain.
J Psychopharmacol. 2019 Aug;33(8):965-974. doi: 10.1177/0269881119857206. Epub 2019 Jun 26.
Chronic drug intake has been associated with negative and positive cognitive effects in elderly people, although subjacent conditions may be confounding factors.
To study the effects on cognitive performance of commonly prescribed medications in a cohort of cognitively normal older adults.
Medication intake was recorded during two years in 1087 individuals 70-85 years old, without neurological or psychiatric conditions. The influence of every drug, drug family and therapeutic group on six cognitive scores and on the conversion to mild cognitive impairment over two years was ascertained by cross-sectional and longitudinal analyses controlling for demographic and clinical variables.
Small effects of several drugs on information processing were found in cross-sectional analyses but only confirmed for a positive effect of vitamin D in case-control analyses. Longitudinal analyses showed no drug effects on the cognitive slopes. Several hypotensive drugs reduced, whereas bromazepam and glucose lowering drugs increased, the conversion rate to mild cognitive impairment with very small effects (=0.3-1%).
Cognitively healthy elderly individuals show minimal negative effects on information processing associated with chronic intake of some drugs probably related to the subjacent condition. Some drugs slightly affect the rate of conversion to mild cognitive impairment. Positive effects of vitamin D, chondroitin, atorvastatin and antihypertensive drugs, and negative effects of antidepressants and benzodiazepines, should be further explored in studies with longer follow-up.
慢性药物摄入与老年人的负面和正面认知效应有关，尽管潜在条件可能是混杂因素。
研究在认知正常的老年人群中，常用药物对认知表现的影响。
在两年时间内，对 1087 名 70-85 岁、无神经或精神疾病的个体记录药物摄入情况。通过横断面和纵向分析，控制人口统计学和临床变量，确定每种药物、药物家族和治疗组对 6 项认知评分的影响，以及对两年内向轻度认知障碍转化的影响。
横断面分析发现，几种药物对信息处理有较小的影响，但仅在病例对照分析中证实维生素 D 有积极影响。纵向分析显示，药物对认知斜率没有影响。几种降压药物降低了向轻度认知障碍转化的速度，而苯二氮䓬类药物和降血糖药物则以很小的影响（=0.3-1%）增加了转化速度。
认知健康的老年人对信息处理有最小的负面影响，这可能与潜在的疾病有关。一些药物对轻度认知障碍的转化率有轻微影响。维生素 D、软骨素、阿托伐他汀和降压药物的积极影响，以及抗抑郁药和苯二氮䓬类药物的消极影响，应在随访时间更长的研究中进一步探索。
