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Longitudinal effects of using and discontinuing CNS medications on cognitive functioning

Elise Koch, Kristina Johnell, Karolina Kauppi
doi: https://doi.org/10.1101/2021.09.13.460082
Elise Koch
1Department of Integrative Medical Biology, Umeå University, Sweden
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  • For correspondence: elise.koch@umu.se
Kristina Johnell
2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Karolina Kauppi
1Department of Integrative Medical Biology, Umeå University, Sweden
2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Abstract

Background Medications acting on the central nervous system (CNS) have been associated with accelerated cognitive decline and increased risk of dementia. However, results are inconsistent and the longitudinal effects of CNS medications on cognitive performance are still not known.

Methods Using longitudinal cognitive data from healthy adults aged 25-100 years (N = 2,475) from four test waves five years apart, we investigated both the link between use of CNS medications (opioids, antidepressants, anxiolytics, hypnotics and sedatives) on cognitive task performance (episodic memory, semantic memory, visuospatial ability) across 15 years, and the effect of discontinuing these medications in linear mixed effects models.

Results We found that opioid use was associated with decline in visuospatial ability, whereas antidepressant use was associated with decline in semantic memory over 15 years. A link between drug discontinuation and cognitive improvement was seen for opioids, antidepressants as well as for anxiolytics, hypnotics and sedatives.

Conclusions Although our results may be confounded by subjacent conditions, they suggest that long-term use of CNS medications may have domain-specific negative effects on cognitive performance over time, whereas the discontinuation of these medications may partly reverse these effects. These results open up for future studies that address subjacent conditions on cognition to develop a more complete understanding of the cognitive effects of CNS medications.

Competing Interest Statement

The authors have declared no competing interest.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.
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Posted September 16, 2021.
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Longitudinal effects of using and discontinuing CNS medications on cognitive functioning
Elise Koch, Kristina Johnell, Karolina Kauppi
bioRxiv 2021.09.13.460082; doi: https://doi.org/10.1101/2021.09.13.460082
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Longitudinal effects of using and discontinuing CNS medications on cognitive functioning
Elise Koch, Kristina Johnell, Karolina Kauppi
bioRxiv 2021.09.13.460082; doi: https://doi.org/10.1101/2021.09.13.460082

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