Significant Association Found Between New Opioid Use and Mortality in Patients with Dementia According to Researchers

Exposure to new opioid use was associated with significantly increased excess mortality, according to research presented at the 2023 meeting of the Alzheimer’s Association International Conference (AAIC). Researchers found a fourfold increased risk of excess mortality in those with dementia who were prescribed opioids for the first time compared with others with dementia not prescribed this treatment. New transdermal fentanyl use was associated with a particularly significant risk of death, with 65.3% of patients receiving this drug dying within the first 180 days of treatment initiation. Researchers also found that new opioid prescriptions were common in the study group.

The matched cohort study included all 75,471 residents of Denmark aged 65 years and older who were diagnosed with dementia between January 1, 2008, and December 31, 2018. Participants who were exposed to new opioid use were matched to unexposed participants. Researchers used Cox proportional hazards models, adjusted for potential confounders, to compare the mortality of the exposed vs unexposed participants within the first 180 days of opioid treatment initiation. Risk was reported by adjusted hazard ratio.

Of the 75,471 participants, 31,619 (42%) were exposed to new opioid use, and 10,642 (33.7%) of these exposed patients died within 180 days of treatment initiation. Only 3980 (6.4%) of the unexposed patients died within this timeframe, demonstrating an increased mortality risk (4.13; 95% CI, 3.98-4.30) for patients who were prescribed opioids. Risk was greatest within the first 14 days (10.95; 95% CI, 9.87-12.15), and strong opioids yielded greater risk (6.34; 95% CI, 6.00-6.69) than weak opioids (2.52; 95% CI, 2.38-2.67).

The presenting author was Christina Jensen-Dahm, MD, PhD, from the Danish Dementia Research Centre of Copenhagen University Hospital.