CNN
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People aged 65 and older with dementia were four times more likely to die within the first six months of taking opioids for pain, if the opioids were stronger such as morphine, oxycodone or fentanyl. were six times more likely to die. to new studies.
People are 11 times more likely to die within the first two weeks of starting an opioid prescription, according to an unpublished study presented Tuesday at the 2023 Alzheimer’s International Conference in Amsterdam.
“Strong pain relievers can affect automatic functions such as heart rate, breathing and swallowing, and older people may already have problems with these things,” said the study. Alzheimer’s Association Chief Medical Officer Maria Carrillo said.
The opioid crisis in the United States is a national “public health emergency.” Management for strategic preparedness and response report. Statistics show that overdoses are skyrocketing, from 47,600 in 2019 to more than 80,000 in 2021, with no end in sight. National Institute on Drug Abuse and the US Centers for Disease Control and Prevention.
During this period, the use of strong opioids, especially transdermal formulations applied to the skin, increased. increasingly common Study lead author Christina Jensendahm, Ph.D., a neurologist and senior researcher at the Danish Dementia Research Center at the Rigschospitalet Hospital in Coffenhagen, Denmark, found that among older people with dementia, some elderly with dementia said to include a person.
“Older people with dementia are often frail and have severe brain damage, which may explain why they cannot tolerate opioids,” Jensendarm said in an email. “We do not believe they were taking drugs for recreational purposes. We believe they died because their brain damage made them intolerant of opioids.
Stronger Opioids Increase Risk
The study analyzed data from more than 75,000 Danes aged 65 and over who were diagnosed with dementia during the decade 2008-2018. Of these, 42% had redeemed an opioid prescription. The study followed the group for 180 days after they started taking opioids and compared the death rates to those of study participants with dementia who did not take opioids.
The study found that more than 33% of the group who started taking opioids died within 180 days, compared with just 6.4% of those with dementia who were not taking pain relievers.
The study found that strong opioids increased the risk of death six-fold, and even higher with the use of transdermal fentanyl patches. If transdermal fentanyl was prescribed as the first prescription, the mortality rate rose to 65.3% for him within his first 180 days, giving him an eight-fold higher risk of death.
However, the greatest risk of death from opioids was in the first 14 days of taking the drug, with people with dementia being 11 times more likely to die in the first two weeks. Previous research It turns out that it can also occur in the case of ordinary person Jensendahm said many people start taking opioids, but those studies “do not find the excess mortality risk to be as large as our study.”
Neurologist Dr. Nicole Purcell, senior director of clinical practice at the Alzheimer’s Association, said in a statement that the study’s findings should sound alarm bells for clinicians and families of people with dementia.
“These new findings further underscore the need for dialogue between patients, families and physicians. We need to monitor it,” Purcell said.
According to Jensendarm, the first choice for pain management is always nonpharmacologic therapies such as exercise, heat, and physical therapy, followed by mild analgesics such as acetaminophen or another nonsteroid if appropriate for the patient. systemic anti-inflammatory drugs should be used.
“As mentioned in CDC guidelines from 2022“Opioid therapy should be considered for pain (acute, subacute, or chronic) only if the benefits to the patient are expected to outweigh the risks,” Jensendarm said.
“It’s hard to make decisions for a loved one who is in pain because with dementia, they probably can’t tell you how they feel,” Carrillo said.
“The message here is that as families and clinicians, we need to be very careful when making decisions about prescribing opioids to people who are not only older but also affected by dementia. it is,” she added. “We could be putting her loved ones in further danger.”
