COGNITIVE EFFECTS OF OPIOIDS IN OLDER ADULTS

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。持续的疼痛，足以造成日常功能的严重损害，影响了多达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。拟议的研究将测量立即释放羟考酮在健康老年人（bb0 - 65岁）中的客观和主观神经认知效应。我们还将描述在特定剂量水平下的药代动力学和药效学。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人（35-55岁）样本中测量客观和主观的神经认知效应和羟考酮的药代动力学。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的影响。这个项目代表了一个新的研究领域，因为到目前为止，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。目前的研究在健康的、没有疼痛症状的老年人中进行，将允许对口服阿片类药物的神经认知作用进行明确的评估，没有疼痛并发症和其他疾病变量。具体来说，这项可行性研究将试图证明老年人更容易受到可耐受初始剂量的羟考酮的神经认知损伤。

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.