Προσοχή με τα νευρολογικά φάρμακα σε ηλικιωμένους.

[Argirios Argiriou]

Neurologically active medications can be risky in older adults

Journal Watch October 21, 2025

Neurologically Active Medications Can Be Risky in Older Adults

Daniel D. Dressler, MD, MSc, MHM, FACP and Rebekah Rollston, MD, MPH, reviewing Stuber MJ et al. J Am Geriatr Soc 2025 Aug 29

Each central nervous system–active medication prescribed at hospital discharge was associated with incrementally higher 12-month readmission rate and mortality.

Older adults with multiple comorbidities and polypharmacy frequently are prescribed central nervous system (CNS)-active medications, but these drugs are associated with potential harms in this vulnerable patient population. Using data from a multinational study, investigators analyzed 2000 hospitalized older patients (median age, 79) with at least three chronic medical conditions who were prescribed five or more medications (i.e., polypharmacy) at hospital discharge. One or more CNS-active medications (i.e., opioids; antipsychotics; anxiolytics; sedatives; antidepressants; antimigraine, antiepileptic, antiparkinsonian, and antidementia agents; parasympathomimetics; and antivertigo medications) were prescribed to 60% of patients.

In analyses adjusted for numerous potential confounders, each additional prescribed CNS-active medication was associated with a significant 7% relative increase in risk for hospital readmission and a 14% relative increase in risk for death at 12 months. Readmissions ranged from ≈45% (for patients taking no CNS drugs) to >60% for those taking ≥5 CNS drugs. Quality-of-life scores and structured measures of functional status also were significantly lower with each additional CNS-active medication prescribed at discharge.

Comment

Hospital stays are opportunities for clinicians to screen older patients for CNS-active medications and to consider deprescribing when clinically appropriate, while also limiting posthospital prescriptions for new CNS-active medications. Although this study doesn't tell us when these medications had strong indications for their use, the results ring true — each additional CNS-active medication at discharge is associated with an increase in risk for readmission and early mortality.

Dr. Rollston is an Instructor in Medicine at Harvard Medical School in Boston, MA.

Citations

Stuber MJ et al. Central nervous system-active medications and risk of hospital readmission in older multimorbid adults. J Am Geriatr Soc 2025 Aug 29; [e-pub]. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος