University of Pennsylvania, Philadelphia, USA.
J Aging Health. 2020 Oct;32(9):1165-1177. doi: 10.1177/0898264319895842. Epub 2020 Jan 6.
Many medications have cognitive impairment, memory loss, amnesia, or dementia as side effects ("cognitive side effects" hereafter), but little is known about trends in the prevalence of these medications or their implications for population-level cognitive impairment. We use data from the National Health and Nutrition Examination Survey (1999-2016) to describe trends in the use of medications with cognitive side effects among adults aged 60+ ( = 16,937) and their implications for cognitive functioning (measured using word learning and recall, animal fluency, and digit symbol substitution assessments). Between 1999 to 2000 and 2015 to 2016, the prevalence of older adults taking one, two, and at least three medications with cognitive side effects increased by 10.2%, 57.3%, and 298.7%, respectively. Compared to non-users, respondents who simultaneously used three or more medications with cognitive side effects scored 0.22 to 0.27 standard deviations lower in word learning and recall ( = .02), digit symbol substitution ( < .01), and the average standardized score of the three assessments ( < .001). Dosage of medications associated with cognitive side effects was not measured. Concurrent use of medications with cognitive side effects among older adults has increased dramatically over the past two decades. The use of such medications is associated with cognitive impairment and may explain for disparities in cognitive function across subgroups. These findings highlight the need for cognitive screenings among patients who consume medications with cognitive side effects. They also highlight the synergic effects of polypharmacy and potential drug-drug interactions that result in cognitive deficits.
许多药物具有认知障碍、记忆力减退、健忘或痴呆等副作用(以下简称“认知副作用”),但对于这些药物的流行趋势及其对人群认知障碍的影响知之甚少。我们利用国家健康和营养调查(1999-2016 年)的数据,描述了 60 岁及以上成年人(n=16937)使用具有认知副作用的药物的趋势及其对认知功能的影响(使用单词学习和回忆、动物流畅性和数字符号替代评估来衡量)。在 1999 年至 2000 年和 2015 年至 2016 年期间,服用一种、两种和至少三种具有认知副作用的药物的老年人比例分别增加了 10.2%、57.3%和 298.7%。与非使用者相比,同时使用三种或更多种具有认知副作用的药物的受访者在单词学习和回忆( <.02)、数字符号替代( <.01)和三个评估的平均标准化得分( <.001)方面的得分分别低了 0.22 到 0.27 个标准差。与认知副作用相关的药物剂量未进行测量。在过去的二十年中,老年人同时使用具有认知副作用的药物的情况急剧增加。这些药物的使用与认知障碍有关,可能解释了认知功能在亚组之间的差异。这些发现强调了对使用具有认知副作用的药物的患者进行认知筛查的必要性。它们还突出了多药并用和潜在药物相互作用导致认知缺陷的协同效应。