Anticholinergic drugs acting preferentially on the peripheral system can also induce cognitive side effects. Practitioners should be aware of steroid-induced dementia and steroid-induced psychosis, and know that risk of delirium increases with polypharmacy. Of 500 patients with cognitive impairment, 70.4% were on multiple medications and 42% were taking benzodiazepines.
Inappropriate treatments for patients with cognitive decline
 
  Keywords
 
 
  
   Anticholinergics
  
 
 
  
   Anticholinesterases
  
 
 
  
   Benzodiazepines
  
 
 
  
   Memantine
  
 
 
  
   Opioids
  
 
 
  
   Polypharmacy
  
 
Abstract
 Introduction
Some treatments are inappropriate for patients with <dis>cognitive decline</dis>.
We analyse their use in 500 patients and present a literature review.
Development
Benzodiazepines produce dependence, and reduce attention, memory, and motor ability.
They can cause disinhibition or aggressive behaviour, facilitate the appearance of delirium, and increase accident and mortality rates in people older than 60.
In subjects over 65, low systolic blood pressure is associated with <dis>cognitive decline</dis>.
Maintaining this figure between 130 and 140 mmHg (145 in patients older than 80) is recommended.
Hypocholesterolaemia < 160 mg/dL is associated with increased morbidity and mortality, aggressiveness, and suicide; high-density lipoprotein (HDL)-cholesterol < 40 mg/dL is associated with <dis>memory loss</dis> and increased vascular and mortality risks.
Old age is a predisposing factor for developing <dis>cognitive disorders</dis> or delirium when taking opioids.
The risks of prescribing anticholinesterases and memantine to patients with <dis>non-Alzheimer dementia</dis> that is not associated with Parkinson disease, <dis>mild cognitive impairment</dis>, or <dis>psychiatric disorders</dis> probably outweigh the benefits.
Anticholinergic drugs acting preferentially on the peripheral system can also induce cognitive side effects.
Practitioners should be aware of <dis>steroid-induced dementia</dis> and steroid-induced psychosis, and know that risk of delirium increases with polypharmacy.
Of 500 patients with <dis>cognitive impairment</dis>, 70.4% were on multiple medications and 42% were taking benzodiazepines.
Both conditions were present in 74.3% of all suspected iatrogenic cases.
Conclusions
Polypharmacy should be avoided, if it is not essential, especially in elderly patients and those with <dis>cognitive impairment</dis>.
Benzodiazepines, opioids and anticholinergics often elicit <dis>cognitive and behavioural disorders</dis>.
Moreover, systolic blood pressure must be kept above 130 mmHg, total cholesterol levels over 160 mg/dL, and HDL-cholesterol over 40 mg/dL in this population.
Abstract
 Introduction
Some treatments are inappropriate for patients with cognitive decline.
We analyse their use in 500 patients and present a literature review.
Development
Benzodiazepines produce dependence, and reduce attention, memory, and motor ability.
They can cause disinhibition or aggressive behaviour, facilitate the appearance of delirium, and increase accident and mortality rates in people older than 60.
In subjects over 65, low systolic blood pressure is associated with cognitive decline.
Maintaining this figure between 130 and 140 mmHg (145 in patients older than 80) is recommended.
Hypocholesterolaemia < 160 mg/dL is associated with increased morbidity and mortality, aggressiveness, and suicide; high-density lipoprotein (HDL)-cholesterol < 40 mg/dL is associated with memory loss and increased vascular and mortality risks.
Old age is a predisposing factor for developing cognitive disorders or delirium when taking opioids.
The risks of prescribing anticholinesterases and memantine to patients with non-Alzheimer dementia that is not associated with Parkinson disease, mild cognitive impairment, or psychiatric disorders probably outweigh the benefits.
Anticholinergic drugs acting preferentially on the peripheral system can also induce cognitive side effects.
Practitioners should be aware of steroid-induced dementia and steroid-induced psychosis, and know that risk of delirium increases with polypharmacy.
Of 500 patients with cognitive impairment, 70.4% were on multiple medications and 42% were taking benzodiazepines.
Both conditions were present in 74.3% of all suspected iatrogenic cases.
Conclusions
Polypharmacy should be avoided, if it is not essential, especially in elderly patients and those with cognitive impairment.
Benzodiazepines, opioids and anticholinergics often elicit cognitive and behavioural disorders.
Moreover, systolic blood pressure must be kept above 130 mmHg, total cholesterol levels over 160 mg/dL, and HDL-cholesterol over 40 mg/dL in this population.
Anticholinergic drugs acting preferentially on the peripheral system can also induce cognitive side effects. Practitioners should be aware of <dis>steroid-induced dementia</dis> and steroid-induced psychosis, and know that risk of delirium increases with polypharmacy. Of 500 patients with <dis>cognitive impairment</dis>, 70.4% were on multiple medications and 42% were taking benzodiazepines.
steroid-induced dementia
DISABILITY
cognitive impairment
DISABILITY