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Potentially inappropriate medications and cognitive performance: cross-sectional results from the ELSA–Brasil study

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A Correction to this article was published on 24 May 2023

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Abstract

Objectives

Potentially inappropriate medications (PIM), especially those with potential effects on the central nervous system, can increase the risk of cognitive impairment. We investigated the association of the use of PIM and PIM that may impair cognition (PIM-Cog) with cognitive performance among older adults.

Methods

In this cross-sectional study with 2,626 participants, PIM and PIM-Cog were defined by the 2019 American Geriatrics Society Beers criteria. We calculated global cognition and memory, verbal fluency, and Trail Making Test B version (TMT-B) z-scores. Linear regression models adjusted for sociodemographic and clinical variables were used to investigate the association between PIM and cognition.

Results

27% and 7% of the sample (mean age = 65.1 ± 4.1 years old, 54% women, and 61% White) used at least one PIM and PIM-cog, respectively. PIM was associated with poor performance in the TMT-B (β = -0.17, 95% Cl = -0.29; -0.05, p = 0.007). PIM-Cog was also associated with poor TMT-B performance (β = -0.08, 95% Cl = -0.15; -0.01, p = 0.025).

Conclusion

The use of PIM and PIM-Cog was associated with poor executive function among older adults. The review of PIM use and the deprescription of these drugs may be an effective way to improve cognitive function.

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Acknowledgements

The ELSA-Brasil study was supported by the Brazilian Ministry of Health and the CNPq (grants 01060010.00RS, 01060212.00BA, 01060300.00ES, 01060278.00MG, 01060115.00SP, 01060071.00RJ). DSF-I received a scholarship from São Paulo Research Foundation (FAPESP) (2017/24066-1).

Author information

Authors and Affiliations

  1. Deparment of Internal Medicine, University of Sao Paulo Medical School, São Paulo, Brazil

    Adriana Nancy Medeiros dos Santos, Isabela M. Benseñor, Alessandra C. Goulart, Andre R. Brunoni & Paulo A. Lotufo

  2. Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil

    Daniela Souza Farias-Itao

  3. Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, SP, Brazil

    Adriana Nancy Medeiros dos Santos, Isabela M. Benseñor, Alessandra C. Goulart, Andre R. Brunoni, Paulo A. Lotufo & Claudia Kimie Suemoto

  4. Department of Social Medicine, Center of Psychiatric Epidemiology (CEPEP), Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil

    Maria Carmen Viana

  5. Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of Sao Paulo Medical School, São Paulo, Brazil

    Andre R. Brunoni

  6. Division of Geriatrics, University of Sao Paulo Medical School, São Paulo, Brazil

    Claudia Kimie Suemoto

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  1. Adriana Nancy Medeiros dos Santos
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Contributions

ANMS: design, statistical analysis, and manuscript draft. DSF-I: statistical analysis, critical revision of the manuscript, and approval of the final manuscript version. IMB: funding, critical revision of the manuscript, and approval of the final manuscript version. ACG: critical revision of the manuscript, and approval of the final manuscript version. ARB: critical revision of the manuscript, and approval of the final manuscript version. MCV: funding, critical revision of the manuscript, and approval of the final manuscript version. PAL: funding, critical revision of the manuscript, and approval of the final manuscript version. CKS: design, statistical analysis, supervision, and manuscript draft.

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Correspondence to Adriana Nancy Medeiros dos Santos.

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The original online version of this article was revised: The correct family name of the 2nd Author is Itao not Iao.

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dos Santos, A.N.M., Farias-Itao, D.S., Benseñor, I.M. et al. Potentially inappropriate medications and cognitive performance: cross-sectional results from the ELSA–Brasil study. Eur J Clin Pharmacol 79, 927–934 (2023). https://doi.org/10.1007/s00228-023-03504-5

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