A groundbreaking study conducted in Denmark has uncovered concerning evidence regarding opioid painkiller usage in elderly individuals diagnosed with dementia. The research indicates that older adults who begin using opioid painkillers after receiving a dementia diagnosis face a significantly higher risk of death, with an alarming 11-fold increase in mortality rates within the first two weeks of opioid initiation. The risk of death persists beyond the initial two weeks, though at a lower rate, with the death risk doubling within 90 days of opioid usage. These findings have prompted researchers and medical professionals to emphasize the importance of carefully considering the risks versus benefits of opioid use in this vulnerable population.
The Danish study investigated all individuals diagnosed with Alzheimer’s disease over a ten-year period and found that one-third of patients who started taking opioids died within 180 days of their first dose. Comparatively, only about 6% of patients in the non-opioid group died during the same time frame. The researchers highlighted the worrisome prevalence of opioid initiation after a dementia diagnosis and underscored the urgent need for thorough risk assessment when considering opioid therapy for elderly individuals with dementia.
Dr. Christina Jensen-Dahm, a co-author of the study and affiliated with the Danish Dementia Research Centre at Copenhagen University Hospital, expressed concern over the increased use of strong opioids among older people with dementia. She pointed out the importance of conducting a careful evaluation of the potential risks and benefits before initiating opioid therapy in this demographic. Notably, the study showed a fourfold increased excess death risk associated with opioids within the first six months, even after accounting for differences between the opioid and non-opioid groups.
The research further revealed that opioids in the form of fentanyl patches were particularly dangerous, with nearly two-thirds of patients dying within the first 180 days compared to about 7% of those without opioid prescriptions. The study encompassed individuals aged 65 and older who had received a dementia diagnosis between 2008 and 2018, with approximately 42% of them filling a prescription for an opioid.
Strong opioids, including morphine, oxycodone (OxyContin), ketobemidone (Ketogan), hydromorphone (Dilaudid, Exalgo), pethidine (Demerol), buprenorphine (Buprenex), and fentanyl, were associated with a sixfold increased risk of death.
Dr. Nicole Purcell, a neurologist and senior director of clinical practice at the Alzheimer’s Association, emphasized that opioids are potent drugs and may pose a significantly higher risk of death for older adults with dementia. She stressed that pain should not go untreated in these individuals, who may be unable to effectively communicate their pain levels. Purcell advised careful consideration and monitoring when prescribing pain medication for this vulnerable population.
The study’s findings were presented at the Alzheimer’s Association International Conference in Amsterdam and underscore the need for further research in diverse populations to better understand the risks associated with opioid use in elderly patients with dementia. As with any research presented at medical meetings, these findings should be regarded as preliminary until published in a peer-reviewed journal. Medical professionals and caregivers are urged to prioritize patient safety and have open discussions with patients and their families when considering the use of opioids in elderly individuals with dementia.