Skip to main content

Advertisement

SpringerLink
Log in

Psychotropic drug use and cognitive rehabilitation practice for elderly patients

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Psychotropic drugs were associated with greater risks of adverse drug reactions, including lower the level of consciousness, cause cognitive dysfunction, relax muscles, cause hypotension and others. However, the effect of psychotropic drug use on rehabilitation outcomes is poorly documented in Japan. Objective To assess the association of increased psychotropic drugs during hospitalization with activities of daily living among elderly patients. Setting This study was conducted at the convalescent rehabilitation ward in the Hitachinaka General Hospital in Japan. Method This retrospective longitudinal cohort study included consecutive patients aged ≥ 65 years between 2010 and 2016. Participants were divided based on presence or absence of increased psychotropic drugs including benzodiazepines, antidepressants, antipsychotics, and antiepileptic drugs during hospitalization. Functional recovery was assessed by the Functional Independence Measure (FIM). Multivariate analyses were performed, adjusting for confounding factors. Main outcome measures Cognitive gain in the Functional Independence Measure. Results We included 631 participants (227 males, 404 females) with a median age of 78 years (interquartile range 73–84 years). Multiple regression analysis revealed that change in psychotropic drug use, cognitive FIM at admission, and age were independently and negatively correlated with cognitive FIM gain. Multiple logistic regression analysis indicated that the “Comprehension” and “Memory” items of the cognitive FIM gain were independently and negatively associated with increased psychotropic drug use. Conclusion Increased psychotropic drug use during hospitalization may predict limited the improvement of cognitive activities of daily living in geriatric patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Eitan N, Levin Y, Ben-Artzi E, Levy A, Neumann M. Effects of antipsychotic drugs on memory functions of schizophrenic patients. Acta Psychiatr Scand. 1992;85(1):74–6.

    Article  CAS  Google Scholar 

  2. Glass J, Lanctôt KL, Herrmann N, Sproule BA, Busto UE. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. BMJ. 2005;331(7526):1169–73.

    Article  Google Scholar 

  3. Kose E, Hirai T, Seki T, Hayashi H. Role of potentially inappropriate medication use in rehabilitation outcomes for geriatric patients after strokes. Geriatr Gerontol Int. 2018;18(2):321–8.

    Article  Google Scholar 

  4. Kose E, Maruyama R, Okazoe S, Hayashi H. Impact of polypharmacy on the rehabilitation outcome of japanese stroke patients in the convalescent rehabilitation ward. J Aging Res. 2016;2016:7957825.

    Article  Google Scholar 

  5. Kose E, Toyoshima M, Okazoe S, Oka R, Shiratsuchi Y, Hayashi H. The relationship between polypharmacy and recovery of activities of daily living among convalescent stroke patients: a propensity score-matched analysis. Eur Geriatr Med. 2017;8(3):250–5.

    Article  Google Scholar 

  6. Kose E, Hirai T, Seki T, Hayashi H. The association of increased drugs use with activities of daily living and discharge outcome among elderly stroke patients. Int J Clin Pharm. 2018. https://doi.org/10.1007/s11096-018-0610-3 Epub ahead of print.

    Article  PubMed  Google Scholar 

  7. Kose E, Hirai T, Seki T, Hidaka S, Hamamoto T. Anticholinergic load negatively correlates with recovery of cognitive activities of daily living for geriatric patients after stroke in the convalescent stage. J Clin Pharm Ther. 2018. https://doi.org/10.1111/jcpt.12706 Epub ahead of print.

    Article  PubMed  Google Scholar 

  8. Kose E, Hirai T, Seki T. Clinical factors affecting potentially inappropriate medications at discharge in older stroke patients. Eur Geriatr Med. 2018;9(2):161–8.

    Article  Google Scholar 

  9. Dutzi I, Schwenk M, Kirchner M, Bauer JM, Hauer K. Cognitive change in rehabilitation patients with dementia: prevalence and association with rehabilitation success. J Alzheimers Dis. 2017;60(3):1171–82.

    Article  Google Scholar 

  10. Weintraub D, Tröster AI, Marras C, Stebbins G. Initial cognitive changes in Parkinson’s disease. Mov Disord. 2018. https://doi.org/10.1002/mds.27330.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Niikawa H, Okamura T, Ito K, Ura C, Miyamae F, Sakuma N, et al. Association between polypharmacy and cognitive impairment in an elderly Japanese population residing in an urban community. Geriatr Gerontol Int. 2017;17(9):1286–93.

    Article  Google Scholar 

  12. Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. The reliability of the functional independence measure:a quantitative review. Arch Phys Med Rehabil. 1996;77(12):1226–32.

    Article  CAS  Google Scholar 

  13. Gray SL, Dublin S, Yu O, Walker R, Anderson M, Hubbard RA, et al. Benzodiazepine use and risk of incident dementia or cognitive decline: prospective population based study. BMJ. 2016;352:i90.

    Article  Google Scholar 

  14. Barker MJ, Greenwood KM, Jackson M, Crowe SF. Cognitive effects of long-term benzodiazepine use: a meta-analysis. CNS Drugs. 2004;18(1):37–48.

    Article  CAS  Google Scholar 

  15. Blazer DG 2nd, Federspiel CF, Ray WA, Schaffner W. The risk of anticholinergic toxicity in the elderly: a study of prescribing practices in two populations. J Gerontol. 1983;38(1):31–5.

    Article  Google Scholar 

  16. Schliebs R, Arendt T. The cholinergic system in aging and neuronal degeneration. Behav Brain Res. 2011;221(2):555–63.

    Article  CAS  Google Scholar 

  17. Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401–7.

    Article  Google Scholar 

  18. Pan YJ, Wu CS, Gau SS, Chan HY, Banerjee S. Antipsychotic discontinuation in patients with dementia: a systematic review and meta-analysis of published randomized controlled studies. Dement Geriatr Cogn Disord. 2014;37(3–4):125–40.

    Article  Google Scholar 

  19. Nishioka S, Wakabayashi H, Yoshida T, Mori N, Watanabe R, Nishioka E. Obese Japanese patients with stroke have higher functional recovery in convalescent rehabilitation wards: a retrospective cohort study. J Stroke Cerebrovasc Dis. 2016;25(1):26–33.

    Article  Google Scholar 

  20. Lagnaoui R, Bégaud B, Moore N, Chaslerie A, Fourrier A, Letenneur L, et al. Benzodiazepine use and risk of dementia: a nested case–control study. J Clin Epidemiol. 2002;55(3):314–8.

    Article  Google Scholar 

  21. Alic A, Pranjic N, Ramic E. Polypharmacy and decreased cognitive abilities in elderly patients. Med Arch. 2011;65(2):102–5.

    Google Scholar 

  22. Lai SW, Lin CH, Liao KF, Su LT, Sung FC, Lin CC. Association between polypharmacy and dementia in older people: a population-based case-control study in Taiwan. Geriatr Gerontol Int. 2012;12(3):491–8.

    Article  Google Scholar 

  23. Jyrkkä J, Enlund H, Lavikainen P, Sulkava R, Hartikainen S. Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population. Pharmacoepidemiol Drug Saf. 2011;20(5):514–22.

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank the manager of Hitachinaka General Hospital who agreed for this study to take place.

Funding

Funding

None.

Author information

Authors and Affiliations

  1. Department of Pharmacotherapy, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi-shi, Chiba, 274-8555, Japan

    Eiji Kose

  2. Department of Pharmacy, Hitachinaka General Hospital, 20-1 Ishikawachou, Hitachinaka-shi, Ibaraki, 312-0057, Japan

    Toshiyuki Hirai & Toshiichi Seki

Authors
  1. Eiji Kose
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshiyuki Hirai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toshiichi Seki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eiji Kose.

Ethics declarations

Conflicts of interest

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kose, E., Hirai, T. & Seki, T. Psychotropic drug use and cognitive rehabilitation practice for elderly patients. Int J Clin Pharm 40, 1292–1299 (2018). https://doi.org/10.1007/s11096-018-0718-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-018-0718-5

Keywords

Search

Navigation