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Posted by Phillipa on January 19, 2012, at 19:17:42
I do not understand why temazapam is included with illicit drugs named in study? Phillipa
From Medscape Medical News > Neurology
Does Illicit Drug Use Harm Cognition in Midlife?
Megan BrooksAuthors and Disclosures
January 18, 2012 A study from the United Kingdom has found no strong evidence that past, or even current, use of illicit drugs is associated with impaired cognitive functioning in early middle age.
"Our results do not exclude, however, possible harmful effects in some individuals who may be heavily exposed to drugs over longer periods of time," Alexandru Dregan, PhD, from the Division of Primary Care and Public Health Sciences, King's College London, United Kingdom, told Medscape Medical News.
In the context of an aging world population, preserving cognitive function is of major public health importance, Dr. Dregan and coauthor Martin C. Gulliford, MD, from King's College London, note in their report, published online December 21 in the American Journal of Epidemiology.
Therefore, understanding risk factors and identifying protective factors for cognitive decline has garnered increasing interest from both researchers and health professionals.
Proposed risk factors for cognitive decline include diabetes, hypertension, stroke, alcohol abuse, smoking, and hypercholesterolemia. Illicit drug use might also play a role in cognitive decline in middle age, although this relation has not been thoroughly investigated and the evidence is "rather inconclusive," the researchers note.
No Strong Links
To investigate, Dr. Dregan and Dr. Gulliford analyzed data from the National Child Development Study from 8992 adults who provided information on any illicit drug use when they were 42 years of age.
The illicit drug categories were cannabis, ecstasy, cocaine, crack cocaine, heroin, amphetamines, hallucinogenic mushrooms, LSD, temazepam, methadone, amyl nitrates (poppers), ketamine, and "other drugs."
When the participants were 50 years old, the researchers analyzed results from standard tests in 3 domains: memory, executive functioning, and overall cognitive functioning. They used multivariable regression analysis to estimate the association between different illicit drug use at 42 years of age and cognitive functioning at 50 years of age.
"We were interested in understanding the long-term impact of illicit drug use on global and specific measures of cognitive function later in life," Dr. Dregan said.
The researchers report that current illicit drug use at 42 years of age was not associated with any of the 3 cognitive functioning domains at 50 years of age.
Ever use of illicit drugs (past or current) was actually associated with marginally higher cognitive functioning at age 50 years for all 3 cognitive function measures and across different groups and types of illicit drugs, after adjusting for a wide range of confounding factors. However, the differences in the 3 cognitive outcomes (range, 0.23 - 0.62) "tended to be small and of doubtful clinical significance," the researchers note.
They speculate that the positive association between ever use of illicit drugs and cognitive functioning suggests that any cognitive deficits associated with immediate drug use might dissipate with time. They also note that those who reported higher drug use were also more highly educated, which could "account for the observed findings in the participants who had ever used illicit drugs."
Results of analyses by severity and length of illicit drug use "tended to point toward a possible long-term negative association between overall and executive cognitive functioning and drug-dependency problems and/or lengthier drug use."
However, none of the main effects were statistically significant. Still, the researchers say, it is "likely that frequent illicit drug use has a greater impact on cognitive function than does occasional use."
Summing up, the researchers say the relation between illicit drug use and cognitive impairment is "complex."
"Overall, we found there was no evidence that current or past drug users had poorer cognitive performance compared to a comparison group who did not report current or past illicit drug use," Dr. Dregan told Medscape Medical News.
He emphasized, however, that the study did not explore the harm that illicit drugs may have on other areas of a person's health and well-being.
He also noted that the accuracy of information about the history of illicit drug use "may be questionable in this study, as it relied on self-reporting. Additional research using clinical measures as well as self-reports could further clarify the present findings," he said.
The authors have disclosed no relevant financial relationships.
Am J Epidemiol. Published online December 21, 2011
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