Pain intensity, physical function, and depressive symptoms associated with discontinuing long-term opioid therapy in older adults with Alzheimer's disease and related dementias.
Pain intensity, physical function, and depressive symptoms associated with discontinuing long-term opioid therapy in older adults with Alzheimer's disease and related dementias.
复制标题
患有阿尔茨海默病和相关痴呆症的老年人停止长期阿片类药物治疗后的疼痛强度、身体功能和抑郁症状。
DOI：
10.1002/alz.13489
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
DeKosky,StevenT
中科院分区：
文献类型：
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作者：
Wei,Yu-JungJenny;Winterstein,AlmutG;Schmidt,Siegfried;Fillingim,RogerB;Daniels,MichaelJ;Solberg,Laurence;DeKosky,StevenT
引言有限的证据存在的协会中断与继续长期阿片类药物治疗（LTOT）与疼痛强度，身体功能，抑郁症患者阿尔茨海默病和相关痴呆症（ADRD）.METHODSA队列研究中的138,059名老年居民轻度至中度ADRD和接收LTOT进行了使用100%的医疗保险养老院样本。停止LTOT的定义是≥ 60天没有再补充阿片类药物。结果是在1年和2年随访期间，从基线到季度评估的疼痛、身体功能和抑郁恶化。对于停止与继续LTOT的居民，1年随访时疼痛和抑郁症状恶化的校正几率分别降低29%和5%，2年随访时分别降低35%和9%。在患有ADRD的老年居民中，与继续LTOT相比，停止LTOT与短期和长期疼痛恶化和抑郁症状降低相关。与较低的短期和长期疼痛恶化相关。停止LTOT与较低的短期和长期抑郁恶化相关。停止LTOT与短期和长期身体功能无关。
INTRODUCTIONLimited evidence exists on the associations of discontinuing versus continuing long‐term opioid therapy (LTOT) with pain intensity, physical function, and depression among patients with Alzheimer's disease and related dementias (ADRD).METHODSA cohort study among 138,059 older residents with mild‐to‐moderate ADRD and receipt of LTOT was conducted using a 100% Medicare nursing home sample. Discontinuation of LTOT was defined as no opioid refills for ≥ 60 days. Outcomes were worsening pain, physical function, and depression from baseline to quarterly assessments during 1‐ and 2‐year follow‐ups.RESULTSThe adjusted odds of worsening pain and depressive symptoms were 29% and 5% lower at the 1‐year follow‐up and 35% and 9% lower at the 2‐year follow‐up for residents who discontinued versus continued LTOT, with no difference in physical function.DISCUSSIONDiscontinuing LTOT was associated with lower short‐ and long‐term worsening pain and depressive symptoms than continuing LTOT among older residents with ADRD.HighlightsDiscontinuing long‐term opioid therapy (LTOT) was associated with lower short‐ and long‐term worsening pain.Discontinuing LTOT was related to lower short‐ and long‐term worsening depression.Discontinuing LTOT was not associated with short‐ and long‐term physical function.