01.06.2014 | Beiträge zum Themenschwerpunkt
Influence of central nervous system-acting drugs on results of cognitive testing in geriatric inpatients
Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 4/2014
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Introduction
Growing evidence shows a high correlation between extensive use of central nervous system-acting drugs (CNSADs) in elderly patients and adverse drug reactions (ADRs) such as falls, fractures, and mortality.
Research question
Are results of cognitive testing with the Mini Mental Status Examination (MMSE) influenced by use of CNSADs?
Setting
Geriatric inpatient service for acute, subacute, and rehabilitation care.
Methods
Secondary combined analysis of two prospective, single-center study cohorts (PROPSYC, 2011 and AGE OUT, 2012) with identical procedure for the MMSE at a tertiary hospital.
Results
Overall, 395 patients were included, 144 male (M) and 251 female (F). Mean age was 80.0 ± 8.4 years (M 76.7 ± 9.1, F 81.9 ± 7.3, p = 0.0000). Mean MMSE points were 22.9 ± 4.8 (M 23.2 ± 4.6, F 22.6 ± 5.0, p = 0.211). In total, 258 patients (65.3 %) used drugs with potential adverse cognitive properties. Analgesics with central activity were given to 117 of 395 patients (29.6 %). Low-potency opioids (tramadol hydrochloride, tilidine) were identified in 60 patients and high-potency opioids in 57 patients. Antidepressants were used in 66 patients, benzodiazepines in 26, and hypnotics in 11, while 38 patients received other CNSADs. We only found significant correlations with the results of cognitive testing for sedatives (diazepam and oxazepam, Pearson’s r − 0.79, p = 0.05), but not for lorazepam.
Conclusion
Our analysis shows an influence of sedatives (diazepam and oxazepam, but not lorazepam) on cognitive testing with the MMSE in users of CNSADs.
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