TY - JOUR
T1 - Incident Functional Limitations Among Community-Dwelling Adults Using Opioids
T2 - A Retrospective Cohort Study Using a Propensity Analysis with the Health and Retirement Study
AU - Pritchard, Kevin T.
AU - Downer, Brian
AU - Raji, Mukaila A.
AU - Baillargeon, Jacques
AU - Kuo, Yong Fang
N1 - Funding Information:
Health and Retirement Study [RAND HRS Longitudinal File]* public use dataset. Produced and distributed by the University of Michigan with funding from the National Institute on Aging (grant number NIA U01AG009740), Ann Arbor, MI, USA (2021).
Funding Information:
This study was supported with funding from the National Institutes on Drug Abuse R01DA039192, the National Institute on Aging K01AG058789 and P30-AG024832, the Agency for Healthcare Research and Quality T32HS02613301, and the National Center for Complementary and Integrative Health F31AT011856. The funders had no role in the design and conduct of the study, the collection, management, analysis, and interpretation of the data, the preparation, review, or approval of the manuscript, and the decision to submit the manuscript for publication.
Funding Information:
We thank Sarah Toombs Smith, PhD, ELS (University of Texas Medical Branch), who aided in proofreading and editing the manuscript. She was not compensated for her contribution beyond her institutional salary.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
PY - 2022/7
Y1 - 2022/7
N2 - Background: Opioid analgesics are commonly used to manage pain; however, it is unclear how they affect patient function. This study examines the association between opioid analgesics and incident limitations in activities of daily living (ADL), instrumental activities of daily living (IADL), and cognitive functioning among community-dwelling older adults. Methods: Data included 10,003 participants of the 2016 and 2018 waves of the Health and Retirement Study, which sampled US adults aged 51–98 years. The primary exposure was self-reported opioid pain medication use in 2016. Outcomes included incident limitations in ADL, IADL, and cognitive functioning in 2018. Statistical methods adjusted for confounding using multivariable logistic regressions, inverse probability of treatment weighting, and propensity scores. Results: Opioid use (adjusted odds ratio [aOR]: 1.34, 95% confidence interval [CI] 1.07–1.68) was associated with a statistically significant higher odds of incident ADL limitation in multivariable regression and in propensity score adjustment (aOR: 1.41, 95% CI 1.13–1.76). The association between opioid use and ADL and IADL limitations was modified by age. Adults aged < 65 years had a higher odds of incident ADL (aOR: 1.83, 95% CI 1.38–2.42) and IADL (aOR: 1.42, 95% CI 1.06–1.90) limitations compared with those aged ≥ 65 years. Conclusions: Community-dwelling adults using opioid analgesics to manage pain may be at risk for incident ADL limitations. Middle-aged adults, compared with those older than 65 years of age, experienced the greatest odds for incident ADL and IADL limitations following opioid use. According to sensitivity analyses, our findings were robust to unmeasured confounding.
AB - Background: Opioid analgesics are commonly used to manage pain; however, it is unclear how they affect patient function. This study examines the association between opioid analgesics and incident limitations in activities of daily living (ADL), instrumental activities of daily living (IADL), and cognitive functioning among community-dwelling older adults. Methods: Data included 10,003 participants of the 2016 and 2018 waves of the Health and Retirement Study, which sampled US adults aged 51–98 years. The primary exposure was self-reported opioid pain medication use in 2016. Outcomes included incident limitations in ADL, IADL, and cognitive functioning in 2018. Statistical methods adjusted for confounding using multivariable logistic regressions, inverse probability of treatment weighting, and propensity scores. Results: Opioid use (adjusted odds ratio [aOR]: 1.34, 95% confidence interval [CI] 1.07–1.68) was associated with a statistically significant higher odds of incident ADL limitation in multivariable regression and in propensity score adjustment (aOR: 1.41, 95% CI 1.13–1.76). The association between opioid use and ADL and IADL limitations was modified by age. Adults aged < 65 years had a higher odds of incident ADL (aOR: 1.83, 95% CI 1.38–2.42) and IADL (aOR: 1.42, 95% CI 1.06–1.90) limitations compared with those aged ≥ 65 years. Conclusions: Community-dwelling adults using opioid analgesics to manage pain may be at risk for incident ADL limitations. Middle-aged adults, compared with those older than 65 years of age, experienced the greatest odds for incident ADL and IADL limitations following opioid use. According to sensitivity analyses, our findings were robust to unmeasured confounding.
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U2 - 10.1007/s40266-022-00953-y
DO - 10.1007/s40266-022-00953-y
M3 - Article
C2 - 35713791
AN - SCOPUS:85132280973
SN - 1170-229X
VL - 39
SP - 559
EP - 571
JO - Drugs and Aging
JF - Drugs and Aging
IS - 7
ER -