COGNITIVE EFFECTS OF OPIOIDS IN OLDER ADULTS

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。持续性疼痛，足以导致日常功能的严重损害，影响高达50%的老年人。到目前为止，还没有研究检查或描述阿片类药物对老年人的神经认知影响。拟定的研究将测量速释羟考酮在健康老年人（>65岁）中的客观和主观神经认知效应。我们还将描述特定剂量水平下的药代动力学和药效学特征。由于老年人对阿片类药物的反应模式可能与年轻人不同，我们还将在健康的中年（35-55岁）样本中测量羟考酮的客观和主观神经认知效应和药代动力学。我们将采用随机、双盲、交叉设计，通过比较中年和老年人组的神经认知功能来研究衰老效应。该项目代表了一个新的研究领域，因为迄今为止还没有严格控制阿片类药物对老年人神经认知影响的研究。本研究在健康的、未经历疼痛的老年人中进行，将允许明确评估口服阿片类药物的神经认知作用，而不会出现疼痛和其他疾病变量的并发症。具体而言，本可行性研究将试图证明老年人更容易受到可耐受的羟考酮初始剂量的神经认知损害的影响。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Persistent pain, sufficient to cause significant impairment in daily functioning affects up to 50 percent of older adults. To date, no studies have examined or characterized neurocognitive effects of opioids in older adults. The proposed study will measure the objective and subjective neurocognitive effects of immediate release oxycodone in healthy older (>65 years) adults. We will also characterize the pharmacokinetics and pharmacodynamics at a specified dose level. Because older adults may evidence a different pattern of response to opioid medication than younger adults, we will also measure objective and subjective neurocognitive effects and pharmacokinetics of oxycodone in a healthy middle age (35-55 years) sample. We will examine aging effects by comparing neurocognitive function of the middle aged and older adults groups using a randomized, double-blind, cross-over design. This project represents a novel area of inquiry because to date there have been no rigorously controlled studies of the neurocognitive effects of opioids in older adults. The present study conducted in healthy, pain-naive older adults will permit an unambiguous assessment of the neurocognitive effects of an oral opioid, without the complications of pain and other disease variables. Specifically, this feasibility study will attempt to demonstrate that older adults are more vulnerable to the neurocognitive impairment of a tolerable initial dose of oxycodone.