Effects of 100 commonly used drugs on cognitive performance in older adults.

 
   Lead Investigator:    Karen Obermann
   Institution      :    St. Louis College of Pharmacy
   E-Mail           :    karen.obermann@gmail.com
   Proposal ID      :    160


   Publications:


1  Obermann KR, Morris JC, Roe CM
   Exploration of 100 commonly used drugs and supplements on cognition in older adults
   Journal Article  Alzheimers Dement,9:724-732,2013,PMC3823812

   PUBLISHED





   Proposal Description:
   There are conflicting reports regarding the effects of medications on cognition in older adults, and overall there is lack of evidence-based data involving drugs and cognitive performance in this population. Discrepancies between studies are likely due to differences in methodology and definition of the cognitive outcome.1  Almost every drug has the potential to interfere with cognition, and older adults may be especially vulnerable to central nervous system effects.2  The older adult population accounts for the largest percentage of medication use, but are often excluded from drug clinical trials for various reasons, such as greater disease burden and differences in pharmacodynamics and pharmacokinetics .3   Although some drugs are more commonly implicated, there is no gold-standard list of drugs that impair cognition, and not all drugs have an equal potential to interfere with cognitive processes.4 There have been many attempts to develop specific criteria for prescribing in older adults, although these criteria rely on consensus panel methods and none focus solely on cognition. The Beers Criteria is most commonly cited, although limitations to these guidelines have been identified, such as lack of clinical outcomes data and consensus based technique.5  As a first step in remedying the lack of knowledge about medication effects on cognitive performance in older adults, we will explore the longitudinal effects on cognition of the top 100 medications most often used by participants in the National Alzheimer???s Coordinating Center database.    1. Verdoux H, Lagnaoui R, Begaud B. Is benzodiazepine use a risk factor for cognitive decline and  dementia? A literature review of epidemiological studies. Psychological Medicine 2004 35(3):307-315.  2. Barton C, Sklenicka J, Sayegh P, Yaffe K. Contraindicated medication use among patients in a memory disorders clinic. Am J Geriatr Pharmacother 2008 6:147-152.  3. Cho S, Lau SWJ, Tandon V, Kumi K, Pfuma E, Abernethy DR. Geria