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Longitudinal effects of using and discontinuing central nervous system medications on cognitive functioning
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital, Norway.ORCID iD: 0000-0003-3727-4470
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0003-4908-341X
2023 (English)In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 32, no 4, p. 446-454Article in journal (Refereed) Published
Abstract [en]

Purpose: To investigate the longitudinal effect of using and discontinuing central nervous system (CNS) medications on cognitive performance.

Methods: Using longitudinal cognitive data from population representative adults aged 25–100 years (N = 2188) from four test waves 5 years apart, we investigated both the link between use of CNS medications (opioids, anxiolytics, hypnotics and sedatives) on cognitive task performance (episodic memory, semantic memory, visuospatial ability) across 15 years, and the effect of discontinuing these medications in linear mixed effects models.

Results: We found that opioid use was associated with decline in visuospatial ability whereas using anxiolytics, hypnotics and sedatives was not associated with cognitive decline over 15 years. A link between drug discontinuation and cognitive improvement was seen for opioids as well as for anxiolytics, hypnotics and sedatives.

Conclusions: Although our results may be confounded by subjacent conditions, they suggest that long-term use of CNS medications may have domain-specific negative effects on cognitive performance over time, whereas the discontinuation of these medications may partly reverse these effects. These results open up for future studies that address subjacent conditions on cognition to develop a more complete understanding of the cognitive effects of CNS medications.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 32, no 4, p. 446-454
Keywords [en]
CNS drugs, cognitive decline, cognitive function, drug discontinuation
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:umu:diva-201345DOI: 10.1002/pds.5569ISI: 000889268200001PubMedID: 36357173Scopus ID: 2-s2.0-85142277047OAI: oai:DiVA.org:umu-201345DiVA, id: diva2:1718986
Funder
Swedish Research Council, 2017–03011Available from: 2022-12-14 Created: 2022-12-14 Last updated: 2023-07-13Bibliographically approved

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Koch, EliseKauppi, Karolina

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