Opioid analgesics increase the risk of pneumonia among persons with Alzheimer’s disease

Opioid analgesics were associated with a 30% increase in the risk of pneumonia in persons with Alzheimer’s disease, a recent study from the University of Eastern Finland shows. The risk was most pronounced in the first two months of use. This is the first study to investigate the association between opioids and pneumonia in this population. The results were published in the Journal of Alzheimer’s Disease.

The risk of pneumonia was highest among those using strong opioids, such as oxycodone or fentanyl, but the risk was also increased among those using buprenorphine, tramadol or codeine. Persons with active cancer were excluded from the study, and other diseases and drug use were accounted for in the analyses. Opioids impair the cough reflex and respiratory functions and cause sedation, possibly underlying the increased risk for pneumonia.

Pneumonia is a severe but relatively common complication among persons with Alzheimer’s disease, and often leads to hospitalisation and even death. Opioids are important in the treatment of severe acute pain, but treatment should be initiated at a low dose and regularly assessed for both benefit and harm. The diagnosis and assessment of pain is challenging among persons with Alzheimer’s disease due to problems in communication.

The study is part of the MEDALZ cohort, which included 5,623 persons with Alzheimer’s disease diagnosed in Finland during 2010-2011. Each person initiating opioid use was matched with a comparison person with Alzheimer’s disease who did not initiate opioid use but had the same age, gender and year of Alzheimer’s diagnosis. Data for the study were derived from Finnish nationwide registers.

For more information, please contact:

Aleksi Hamina, MSc (Pharm), Early Stage Researcher, School of Pharmacy, University of Eastern Finland, Kuopio, aleksi.hamina(at)uef.fi, tel. +358503537868

Sirpa Hartikainen, Professor, School of Pharmacy, University of Eastern Finland Kuopio, sirpa.hartikainen(at)uef.fi

Research article:
Hospital-treated pneumonia associated with opioid use among community dwellers with Alzheimer’s disease. Aleksi Hamina, Heidi Taipale, Niina Karttunen Antti Tanskanen, Jari Tiihonen, Anna-Maija Tolppanen and Sirpa Hartikainen. Journal of Alzheimer’s Disease. Published online 20 May 2019. DOI: 10.3233/JAD-181295

About Us

The University of Eastern Finland, UEF, is one of the largest universities in Finland. The activities of the UEF underscore multidisciplinarity, and the university is especially strong in research related to forests and the environment, health and well-being, and new technologies and materials. The UEF offers teaching in more than 100 major subjects. In addition to the high standard of teaching, the university offers its students a modern study environment, which is under constant development. The university comprises four faculties: the Philosophical Faculty, the Faculty of Science and Forestry, the Faculty of Health Sciences, and the Faculty of Social Sciences and Business Studies. The university’s campuses are located in the heart of beautiful eastern Finland in Joensuu, Kuopio and Savonlinna. The UEF is home to approximately 15 000 students and nearly 2 800 members of staff.

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