Life long changes in cognitive ability are associated with prescribed medications in old age

J. M. Starr, B. McGurn, M. Whiteman, A. Pattie, Lawrence Jeffrey Whalley, I. J. Deary

    Research output: Contribution to journalArticle

    52 Citations (Scopus)

    Abstract

    Objectives To determine the association between prescribed medication and life long changes in cognitive ability.

    Design Retrospective cohort study.

    Setting Community residents of a largely urban region of South East Scotland.

    Participants Four hundred and seventy-eight survivors of the 1932 Scottish Mental Health Survey (n = 87 498) without dementia.

    Measurements The Moray House Test (MHT) of intelligence administered at age 11 and age 80 years. Hospital Anxiety and Depression Scale (HADS) score, history of disease and current prescribed medications age 80 years.

    Results After adjusting for sex, neuroactive drugs had a detrimental effect on life long cognitive change age (F = 12.2, p = 0.001, partial eta-squared = 0.026), statins a beneficial effect (F = 5.78, p = 0.017, partial eta-squared = 0.013) and polypharmacy a detrimental effect (F = 6.46, p = 0.011, partial eta-squared = 0.014). In the optimal model estimated marginal means revealed: a relative improvement for statin users, IQ age 11 = 93.2 (95% Cl 87.9-98.4) and age 80 = 100.6 (95% CI 95.3-105.9); compared with non-users, IQ age 11 = 100.9 (95% CI 99.4-102.3) and age 80 = 100.0 (95% CI 98.6-101.5).

    Conclusions Clinically, the degree to which drugs impair cognition in relatively fit, older people may not be apparent. However, in population terms, medication use, particularly polypharmacy, is important. Statins, used as currently indicated for cardiovascular disease, appear promising in ameliorating cognitive decline in older people. However, firm recommendation of their use should await the outcome of ongoing randomised clinical trials. Copyright (C) 2004 John Wiley Sons, Ltd.

    Original languageEnglish
    Pages (from-to)327-332
    Number of pages5
    JournalInternational Journal of Geriatric Psychiatry
    Volume19
    DOIs
    Publication statusPublished - 2004

    Keywords

    • cognition
    • older people
    • drugs
    • 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors
    • MINI-MENTAL-STATE
    • BLOOD-PRESSURE
    • DEMENTIA
    • IMPAIRMENT
    • DECLINE
    • RISK
    • POPULATION
    • PEOPLE
    • PREVENTION
    • PREVALENCE

    Cite this

    Life long changes in cognitive ability are associated with prescribed medications in old age. / Starr, J. M.; McGurn, B.; Whiteman, M.; Pattie, A.; Whalley, Lawrence Jeffrey; Deary, I. J.

    In: International Journal of Geriatric Psychiatry, Vol. 19, 2004, p. 327-332.

    Research output: Contribution to journalArticle

    Starr, J. M. ; McGurn, B. ; Whiteman, M. ; Pattie, A. ; Whalley, Lawrence Jeffrey ; Deary, I. J. / Life long changes in cognitive ability are associated with prescribed medications in old age. In: International Journal of Geriatric Psychiatry. 2004 ; Vol. 19. pp. 327-332.
    @article{5e7323c0b8cc4da9b6c6442f67a30587,
    title = "Life long changes in cognitive ability are associated with prescribed medications in old age",
    abstract = "Objectives To determine the association between prescribed medication and life long changes in cognitive ability.Design Retrospective cohort study.Setting Community residents of a largely urban region of South East Scotland.Participants Four hundred and seventy-eight survivors of the 1932 Scottish Mental Health Survey (n = 87 498) without dementia.Measurements The Moray House Test (MHT) of intelligence administered at age 11 and age 80 years. Hospital Anxiety and Depression Scale (HADS) score, history of disease and current prescribed medications age 80 years.Results After adjusting for sex, neuroactive drugs had a detrimental effect on life long cognitive change age (F = 12.2, p = 0.001, partial eta-squared = 0.026), statins a beneficial effect (F = 5.78, p = 0.017, partial eta-squared = 0.013) and polypharmacy a detrimental effect (F = 6.46, p = 0.011, partial eta-squared = 0.014). In the optimal model estimated marginal means revealed: a relative improvement for statin users, IQ age 11 = 93.2 (95{\%} Cl 87.9-98.4) and age 80 = 100.6 (95{\%} CI 95.3-105.9); compared with non-users, IQ age 11 = 100.9 (95{\%} CI 99.4-102.3) and age 80 = 100.0 (95{\%} CI 98.6-101.5).Conclusions Clinically, the degree to which drugs impair cognition in relatively fit, older people may not be apparent. However, in population terms, medication use, particularly polypharmacy, is important. Statins, used as currently indicated for cardiovascular disease, appear promising in ameliorating cognitive decline in older people. However, firm recommendation of their use should await the outcome of ongoing randomised clinical trials. Copyright (C) 2004 John Wiley Sons, Ltd.",
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    author = "Starr, {J. M.} and B. McGurn and M. Whiteman and A. Pattie and Whalley, {Lawrence Jeffrey} and Deary, {I. J.}",
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    TY - JOUR

    T1 - Life long changes in cognitive ability are associated with prescribed medications in old age

    AU - Starr, J. M.

    AU - McGurn, B.

    AU - Whiteman, M.

    AU - Pattie, A.

    AU - Whalley, Lawrence Jeffrey

    AU - Deary, I. J.

    PY - 2004

    Y1 - 2004

    N2 - Objectives To determine the association between prescribed medication and life long changes in cognitive ability.Design Retrospective cohort study.Setting Community residents of a largely urban region of South East Scotland.Participants Four hundred and seventy-eight survivors of the 1932 Scottish Mental Health Survey (n = 87 498) without dementia.Measurements The Moray House Test (MHT) of intelligence administered at age 11 and age 80 years. Hospital Anxiety and Depression Scale (HADS) score, history of disease and current prescribed medications age 80 years.Results After adjusting for sex, neuroactive drugs had a detrimental effect on life long cognitive change age (F = 12.2, p = 0.001, partial eta-squared = 0.026), statins a beneficial effect (F = 5.78, p = 0.017, partial eta-squared = 0.013) and polypharmacy a detrimental effect (F = 6.46, p = 0.011, partial eta-squared = 0.014). In the optimal model estimated marginal means revealed: a relative improvement for statin users, IQ age 11 = 93.2 (95% Cl 87.9-98.4) and age 80 = 100.6 (95% CI 95.3-105.9); compared with non-users, IQ age 11 = 100.9 (95% CI 99.4-102.3) and age 80 = 100.0 (95% CI 98.6-101.5).Conclusions Clinically, the degree to which drugs impair cognition in relatively fit, older people may not be apparent. However, in population terms, medication use, particularly polypharmacy, is important. Statins, used as currently indicated for cardiovascular disease, appear promising in ameliorating cognitive decline in older people. However, firm recommendation of their use should await the outcome of ongoing randomised clinical trials. Copyright (C) 2004 John Wiley Sons, Ltd.

    AB - Objectives To determine the association between prescribed medication and life long changes in cognitive ability.Design Retrospective cohort study.Setting Community residents of a largely urban region of South East Scotland.Participants Four hundred and seventy-eight survivors of the 1932 Scottish Mental Health Survey (n = 87 498) without dementia.Measurements The Moray House Test (MHT) of intelligence administered at age 11 and age 80 years. Hospital Anxiety and Depression Scale (HADS) score, history of disease and current prescribed medications age 80 years.Results After adjusting for sex, neuroactive drugs had a detrimental effect on life long cognitive change age (F = 12.2, p = 0.001, partial eta-squared = 0.026), statins a beneficial effect (F = 5.78, p = 0.017, partial eta-squared = 0.013) and polypharmacy a detrimental effect (F = 6.46, p = 0.011, partial eta-squared = 0.014). In the optimal model estimated marginal means revealed: a relative improvement for statin users, IQ age 11 = 93.2 (95% Cl 87.9-98.4) and age 80 = 100.6 (95% CI 95.3-105.9); compared with non-users, IQ age 11 = 100.9 (95% CI 99.4-102.3) and age 80 = 100.0 (95% CI 98.6-101.5).Conclusions Clinically, the degree to which drugs impair cognition in relatively fit, older people may not be apparent. However, in population terms, medication use, particularly polypharmacy, is important. Statins, used as currently indicated for cardiovascular disease, appear promising in ameliorating cognitive decline in older people. However, firm recommendation of their use should await the outcome of ongoing randomised clinical trials. Copyright (C) 2004 John Wiley Sons, Ltd.

    KW - cognition

    KW - older people

    KW - drugs

    KW - 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors

    KW - MINI-MENTAL-STATE

    KW - BLOOD-PRESSURE

    KW - DEMENTIA

    KW - IMPAIRMENT

    KW - DECLINE

    KW - RISK

    KW - POPULATION

    KW - PEOPLE

    KW - PREVENTION

    KW - PREVALENCE

    U2 - 10.1002/gps.1093

    DO - 10.1002/gps.1093

    M3 - Article

    VL - 19

    SP - 327

    EP - 332

    JO - International Journal of Geriatric Psychiatry

    JF - International Journal of Geriatric Psychiatry

    SN - 0885-6230

    ER -