August 20, 2019
People with Alzheimer’s disease who are treated with opioid painkillers are at increased risk of developing pneumonia. The risk was greatest in the first two months the drugs were given, a new study found.
For the study, researchers at the University of Eastern Finland looked at 5,623 men and women in Finland who had been given a diagnosis of Alzheimer’s disease. All lived at home.
Each person who began taking opioids was matched with a comparison person with Alzheimer’s disease who did not initiate opioid use, but who was of a similar age and gender and who had had Alzheimer’s disease for a similar number of years.
Use of the potent painkillers was tied to a 30 percent increased risk of developing pneumonia in those with Alzheimer’s disease, the researchers found. The risk of pneumonia was highest among those who were prescribed strong opioids, such as oxycodone or fentanyl. But even those using milder painkillers, like buprenorphine, tramadol or codeine, were at increased risk of developing pneumonia.
Persons with active cancer, who often experience debilitating pain and other conditions, were not included in the study. The results were published in the Journal of Alzheimer’s Disease.
Pneumonia is a severe but relatively common complication among persons with Alzheimer’s disease, and often leads to hospitalization and even death. Opioids impair the cough reflex and respiratory functions and cause sedation, which likely contributes to the increased risk for pneumonia.
The diagnosis and assessment of pain can be challenging among persons with Alzheimer’s disease because it can be hard to communicate with these patients. But opioids can be important part of a treatment plan for someone with Alzheimer’s disease.
Treatment, however, should be initiated at a low dose and regularly assessed for both benefit and harm, the authors say. Special care should be taken in monitoring these patients, particularly during the first couple months of treatment, when the risk of pneumonia is highest.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Aleksi Hamina, Heidi Taipale, Niina Karttunen, et al: Hospital-treated pneumonia associated with opioid use among community dwellers with Alzheimer’s disease. Journal of Alzheimer’s Disease. Published online May 20, 2019.