Recent research presented at the Alzheimer’s Association International Conference (AAIC) in Amsterdam reveals a concerning link between opioid use and increased mortality risk among dementia patients. The study, conducted in Denmark over a 10-year period, examined individuals aged 65 and older diagnosed with Alzheimer’s disease who were prescribed opioids. A startling one-third of these patients died within 180 days of starting opioid medication.
This represents a five-fold increase in death risk compared to dementia patients who did not use opioids. Alarmingly, the risk was even higher within the first two weeks of opioid use, soaring to an eleven-fold increase. The study also highlighted the particularly high risk associated with fentanyl patches, with nearly two-thirds of patients using them dying within 180 days.
Researchers observed a six-fold increase in mortality risk for patients taking strong opioids such as morphine, oxycodone, ketobemidone, hydromorphone, pethidine, buprenorphine, and fentanyl. Dr. Christina Jensen-Dahm of Copenhagen University Hospital, who led the study, expressed concern over these findings, noting the substantial increase in strong opioid use among older adults with dementia in recent years.
While the study underscores the need for cautious opioid prescribing in dementia patients, experts also emphasize the importance of effective pain management for this vulnerable group. Dr. Nicole Purcell of the Alzheimer’s Association stressed the need for open communication between patients, families, and physicians to carefully weigh the risks and benefits of pain medication. She advocates for thorough patient monitoring when opioids are deemed necessary.
Although further research is needed to pinpoint the exact reasons for the elevated mortality risk, Dr. Jensen-Dahm suggests that older adults with dementia may be more susceptible to the adverse effects of opioids, such as sedation, confusion, respiratory issues, and falls. Their pre-existing brain disorders and often frail physical condition could make them less tolerant to these side effects. The study also mentioned that atypical antipsychotics, used to treat psychiatric conditions, have been linked to increased mortality in older dementia patients.
