Frequently used medication identified as potential cause of cognitive decline
Gabapentin Use Linked to Increased Risk of Dementia and Mild Cognitive Impairment in Adults
A large-scale study has found a significant association between the use of gabapentin, a common medication for chronic low back pain, and an increased risk of dementia and mild cognitive impairment (MCI) in adults, particularly those aged 35-64.
The study, which analyzed over 1.4 million adults with chronic low back pain between 2004 and 2024, found that patients prescribed gabapentin six or more times had a 29% higher risk of dementia and an 85% higher risk of MCI compared to non-users. The risks were more than doubled for both dementia and MCI in adults aged 18-64, with the 35-64 age group showing the highest risk ratios. Higher prescription frequency (12 or more times) corresponded to even greater risks, indicating a dose-response relationship.
The study, conducted using data from TriNetX, a health research network containing electronic health records from 60 U.S. healthcare organizations, controlled for demographics, co-existing conditions, and the use of other pain-relieving drugs. It excluded patients with prior dementia, epilepsy, cancer, or stroke.
The researchers caution that while the study establishes an association, it does not prove cause and effect. However, the findings highlight the importance of careful risk-benefit assessment when prescribing gabapentin for chronic pain in adults aged 35-64.
Gabapentin, a seizure medication, is often prescribed off-label for low back pain. Possible side effects of its use include fatigue, dizziness, headache, difficulty speaking, memory loss, movement problems, and unusual eye movements and double vision.
The study also found a similar pattern in those between the ages of 50 and 64. Researchers recommend that clinicians monitor cognitive function in patients on long-term gabapentin, especially younger adults, and advise patients to report any cognitive symptoms early.
The study also suggests the need for close monitoring of adult patients prescribed gabapentin to assess for potential cognitive decline. As of 2023, gabapentin was ranked #10 in the list of the top 50 most commonly prescribed drugs in the U.S.
While the study provides a foundation for further research on whether gabapentin plays a causal role in the development of dementia and cognitive decline, it does not establish causation. The researchers have called for more studies to investigate this association further.
It is important to note that the study did not account for dose or length of gabapentin use, and no sources are provided for the statement about stroke recovery and prevention.
The gabapentinoid class of drugs, which includes gabapentin, has been associated with a 30 percent higher risk of hip fracture. Patients with 12 or more prescriptions were 40% more likely to develop dementia and 65% more likely to develop MCI than those prescribed between three and 11 times.
In conclusion, the study provides evidence that gabapentin use is linked to a significantly increased risk of dementia and MCI in adults, particularly those aged 35-64. While more research is needed to establish causation, clinicians are advised to monitor cognitive function in patients on long-term gabapentin, especially younger adults, and to advise patients to report any cognitive symptoms early.
Science has shown a link between the use of gabapentin, a medication often prescribed for chronic pain and health-and-wellness issues like low back pain, and an increased risk of dementia and mild cognitive impairment (MCI) in adults, specifically those aged 35-64. The study also suggests a need for mental-health considerations, as the risks for both dementia and MCI in adults aged 18-64 were significantly higher, with the 35-64 age group showing the highest risk ratios.
