AI Article Synopsis
- The study explored the effects of long-term use of central nervous system depressants (CNSDs) in older adults, focusing on mortality and health-related quality of life (HRQoL).
- Conducted in Norway, the study followed 246 participants aged 65-90 over a 5-year period, finding that 31.7% had died by follow-up, with higher mortality rates linked to long-term CNSD use.
- The results indicated that being older and male increased mortality risk, but there was no significant difference in HRQoL changes between CNSD users and non-users among survivors.
Article Abstract
Objectives: Disease and medication use in older age is a consequence of age-related declining health. Multimorbidity followed by polypharmacy is common. Central nervous system depressing (CNSD) drugs such as opioids, benzodiazepines and z-hypnotics are not recommended for long-term use in older adults but are in use by many. We aimed to assess mortality and change in health-related quality of life (HRQoL) in older adults with long-term use of CNSDs.
Method: A prospective observational study was conducted at Akershus University Hospital, Norway, 2017-2019, with follow-up in 2021-2022, including 246 participants aged 65-90. At 5-year follow-up, 78 (32%) participants had passed away. Mortality data were collected from patient electronic health records. Of the surviving 168 (68%), we collected further follow-up data from 38 (16%) participants. Follow-up included demographic and clinical data. The EuroQuol Group EQ-5D-5L questionnaire was used to measure HRQoL. Analysis include Cox regression model for survival data and linear mixed model for change in HRQoL over time.
Results: At follow-up, 78 (31.7%) were deceased. Mean survival time was 3.3 years. Total time for survival data was 4.7 years. Mortality was higher among participants with long-term use of CNSD (HR 1.9 95% CI (1.2 to 3.2), p=0.01). The multivariable analysis found being older (HR 1.1 95% CI (1.0 to 1.1), p=0.020) and male sex (HR 2.1 95% CI (1.2 to 3.5), p=0.008) to be associated with increased risk of mortality. According to the linear mixed model (n=38), there was no significant difference between surviving users and non-users in change in HRQoL EQ-5D-5L index from baseline to follow-up.
Conclusion: Mortality was higher for long-term users of CNSDs at 5-year follow-up. Being older and male sex were associated with mortality. Among survivors, there was no significant difference between the groups in change of HRQoL over time.
Trial Registration Number: NCT03162081; 22 May 2017.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882342 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2023-079347 | DOI Listing |
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