Background
Methods
Participants
Methods and measures
Statistical analyses
Results
Background data
Use of CNS medications
Medication | Number of users | |||||
---|---|---|---|---|---|---|
Baseline | Follow-up | Both baseline and follow-up | ||||
N | % | N | % | N | % of users at baseline | |
Opioids | 9 | 2 | 43 | 7 | 3 | 33 |
Anticholinergics | 78 | 14 | 104 | 18 | 37 | 47 |
Antiepileptics | 7 | 1 | 7 | 1 | 3 | 43 |
Benzodiazepines or related drugs | 115 | 20 | 181 | 32 | 84 | 73 |
Antipsychotics | 28 | 5 | 36 | 6 | 11 | 39 |
Antidepressants | 19 | 3 | 71 | 13 | 14 | 74 |
At least one CNS medication | 171 | 30 | 262 | 46 | 133 | 78 |
Combinations of medications | Sex | Age | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Both | Men | Women | 65-74 | 75+ | ||||||
(N = 565) | (N = 227) | (N = 338) | (N = 439) | (N = 126) | ||||||
N | % | N | % | N | % | N | % | N | % | |
Opioid and
| ||||||||||
anticholinergic | 1 | 0.2 | 0 | 0 | 1 | 0.3 | 1 | 0.2 | 0 | 0 |
antiepileptic | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
benzodiazepine or related drug | 4 | 0.7 | 0 | 0 | 4 | 1.2 | 1 | 0.2 | 3 | 2.4 |
antipsychotic | 2 | 0.4 | 0 | 0 | 2 | 0.6 | 2 | 0.5 | 0 | 0 |
antidepressant | 1 | 0.2 | 0 | 0 | 1 | 0.3 | 1 | 0.2 | 0 | 0 |
any of the above drugs | 6 | 1.1 | 0 | 0 | 6 | 1.8 | 3 | 0.7 | 3 | 2.3 |
Anticholinergic and
| ||||||||||
antiepileptic | 1 | 0.2 | 1 | 0.4 | 0 | 0 | 0 | 0 | 1 | 0.8 |
benzodiazepine or related drug | 32 | 5.7 | 11 | 4.8 | 21 | 6.2 | 19 | 4.3 | 13 | 10.3 |
antipsychotic | 22 | 3.9 | 6 | 2.6 | 16 | 4.7 | 13 | 3.0 | 9 | 7.1 |
antidepressant | 9 | 1.6 | 3 | 1.3 | 6 | 1.8 | 8 | 1.8 | 1 | 0.8 |
any of the above drugs | 48 | 8.5 | 15 | 6.6 | 33 | 9.8 | 31 | 7.1 | 17 | 13.5 |
Antiepileptic and
| ||||||||||
antidepressant | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
benzodiazepine or related drug | 3 | 0.5 | 3 | 1.3 | 0 | 0 | 2 | 4.6 | 1 | 0.8 |
antipsychotic | 1 | 0.2 | 1 | 0.4 | 0 | 0 | 0 | 0 | 1 | 0.8 |
any of the above drugs | 3 | 0.5 | 3 | 1.3 | 0 | 0 | 2 | 0.5 | 1 | 0.8 |
Benzodiazepine or related drug and
| ||||||||||
antipsychotic | 13 | 2.3 | 5 | 2.2 | 8 | 2.4 | 7 | 1.6 | 6 | 4.8 |
antidepressant | 12 | 2.1 | 2 | 0.9 | 10 | 3.0 | 9 | 2.1 | 3 | 2.4 |
any of the above drugs | 46 | 8.1 | 14 | 6.2 | 32 | 9.5 | 28 | 6.4 | 18 | 14.3 |
Antipsychotic and
| ||||||||||
antidepressant | 5 | 0.9 | 1 | 0.4 | 4 | 1.2 | 3 | 0.7 | 2 | 1.6 |
any of the above drugs | 28 | 5.0 | 7 | 3.1 | 21 | 6.2 | 17 | 3.9 | 11 | 8.7 |
Antidepressant and
| ||||||||||
any of the above drugs | 19 | 3.4 | 4 | 1.8 | 15 | 4.4 | 15 | 3.4 | 4 | 3.2 |
Changes in cognitive functioning during follow-up
Population | MMSE sum score | ||
---|---|---|---|
At baseline | After 7.6-year follow-up | p-value1
| |
(1990-1991) | (1998-1999) | ||
Mean ± SD | Mean ± SD | ||
Total population (N = 565) | 28.1 ± 1.9 | 26.1 ± 4.8 | < 0.001 |
Men (N = 227) | 28.3 ± 1.7 | 26.7 ± 3.4 | < 0.001 |
Women (N = 338) | 27.9 ± 2.0 | 25.7 ± 3.6 | < 0.001 |
64-74 yrs (N = 439) | 28.2 ± 1.8 | 26.9 ± 3.6 | < 0.001 |
≥75 yrs (N = 126) | 27.5 ± 2.0 | 23.3 ± 6.7 | < 0.001 |
Background data and the use of CNS medications
CNS medication users (N = 171) | CNS medication non-users (N = 394) | ||||
---|---|---|---|---|---|
Background variable | Mean ± SD | Mean ± SD | p-value1
| ||
Age | 71.9 ± 5.7 | 69.9 ± 4.9 | < 0.001 | ||
Number of all medications | 4.5 ± 2.7 | 1.6 ± 1.9 | < 0.001 | ||
Number of regularly taken medications | 3.3 ± 2.5 | 1.3 ± 1.7 | < 0.001 | ||
Number of medications taken as needed | 1.2 ± 1.2 | 0.3 ± 0.7 | < 0.001 | ||
Number of all medications excluding CNS medications | 3.2 ± 2.5 | 1.6 ± 1.9 | < 0.001 | ||
Number of regularly taken medications excluding CNS medications | 2.4 ± 2.1 | 1.3 ± 1.7 | < 0.001 | ||
Number of medications taken as needed excluding CNS medications | 0.8 ± 1.0 | 0.3 ± 0.7 | < 0.001 | ||
N | % | N | % | p-value2
| |
Sex (woman) | 120 | 70.2 | 218 | 55.3 | < 0.001 |
Marital status | |||||
Married | 15 | 8.8 | 46 | 11.7 | 0.076 |
Unmarried or divorced | 101 | 59.1 | 256 | 65.0 | |
Widowed | 55 | 32.2 | 92 | 23.4 | |
Place of living | |||||
At home alone | 64 | 37.4 | 105 | 26.6 | 0.007 |
At home with other person | 105 | 61.4 | 288 | 73.1 | |
In institution or nursing home | 2 | 1.2 | 1 | 0.3 | |
Education | |||||
Less than basic | 13 | 7.6 | 19 | 4.8 | 0.423 |
Basic | 144 | 84.2 | 340 | 86.3 | |
More than basic | 14 | 8.2 | 35 | 8.9 | |
Ability to walk | |||||
Independent | 148 | 86.5 | 375 | 95.2 | < 0.001 |
With tools | 22 | 12.9 | 18 | 4.6 | |
Needs to be assisted | 0 | 0 | 1 | 0.3 | |
Diagnoses | |||||
Depression | 38 | 22.2 | 25 | 6.4 | < 0.001 |
Alcohol related disease | 1 | 0.6 | 5 | 1.3 | 0.673 |
Hypertension | 59 | 34.5 | 100 | 25.4 | 0.027 |
Hypercholesterolemia | 32 | 18.7 | 60 | 15.2 | 0.303 |
Diabetes mellitus (type I or II) | 7 | 4.1 | 25 | 6.3 | 0.288 |
TIA | 8 | 4.7 | 3 | 0.8 | 0.004 |
Cerebral infarct | 1 | 0.6 | 3 | 0.8 | 1.000 |
Cerebral haemorrage | 1 | 0.6 | 1 | 0.3 | 0.514 |
Cerebral trauma | 2 | 1.2 | 4 | 1.0 | 1.000 |
Malignant tumour or cancer | 5 | 0.3 | 17 | 4.3 | 0.432 |
HIV, lues or borreliosis | 0 | 0 | 0 | 0 | 1.000 |
Dementia (all types) | 2 | 1.2 | 0 | 0 | 0.091 |
CNS medications and their combinations and cognitive change
One CNS medication
Medication | Sex | Baseline MMSE | MMSE during follow-up | Change in MMSE | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Users | Controls | Users | Controls | Users | Controls | ||||||||
N | Mean ± SD | N | Mean ± SD | p1 | Mean ± SD2
| Mean ± SD2
| p2 | Mean ± SD | Mean ± SD | p for diff | adjusted p | ||
Opioids1
| M+W | 9 | 27.7 ± 1.8 | 384 | 28.2 ± 1.8 | 0.276 | 21.2 ± 7.8 | 26.5 ± 4.5 | 0.011 | -6.4 ± 7.3 | -1.7 ± 4.3 | 0.007 | 0.032 |
Opioids2
| M+W | 9 | 27.7 ± 1.8 | 556 | 28.1 ± 1.9 | 0.372 | 21.2 ± 7.8 | 26.2 ± 4.7 | 0.018 | -6.4 ± 7.3 | -1.9 ± 4.4 | 0.009 | 0.021 |
Anticholinergics2
| M | 29 | 28.2 ± 1.8 ± | 198 | 28.3 ± 1.7 | 0.938 | 25.0 ± 4.4 | 27.0 ± 3.2 | 0.015 | -3.2 ± 4.0 | -1.3 ± 2.9 | 0.021 | 0.002 |
Opioid and
| |||||||||||||
any other CNS medication1
| M+W | 6 | 27.3 ± 2.0 | 384 | 28.2 ± 1.8 | 0.020 | 18.8 ± 8.7 | 26.5 ± 4.5 | 0.010 | -8.5 ± 8.0 | -1.7 ± 4.3 | 0.004 | 0.007 |
Benzodiazepine or related drug and
| |||||||||||||
opioid1
| M+W | 4 | 26.5 ± 1.7 | 384 | 28.2 ± 1.8 | 0.052 | 15.8 ± 8.7 | 26.5 ± 4.5 | 0.004 | -10.8 ± 9.0 | -1.7 ± 4.3 | 0.006 | 0.002 |
opioid1
| W | 4 | 26.5 ± 1.7 | 210 | 28.0 ± 2.0 | 0.097 | 15.8 ± 8.7 | 26.0 ± 5.2 | 0.007 | -10.8 ± 9.0 | -2.0 ± 5.1 | 0.010 | 0.024 |