(Press-News.org) INDIANAPOLIS -- Many adults with diabetes and the associated complication of peripheral neuropathy, which can be painful as well as harmful, are often prescribed drugs at doses and for durations that could impose an increased risk of cognitive impairment.
A new study, led by Regenstrief Institute and Purdue University College of Pharmacy Research Scientist Noll Campbell, PharmD, M.S., is one of the first explorations of prescribing patterns of tricyclic antidepressants for treatment of diabetic peripheral neuropathy at healthcare facilities predominantly serving diverse populations of low socioeconomic status.
With a study population of adults 18 years and older that was 44 percent White and 42 percent Black, the researchers found that almost two-thirds of the prescribed tricyclic antidepressants were above the dosage threshold that has been associated with an increased risk of dementia in older adults. Black patients were more likely to be prescribed these drugs at higher doses, disproportionately increasing their risk for dementia compared with White patients.
The current body of evidence, much of it established and confirmed in studies by Regenstrief Institute research scientists, supports the existence of a relationship between long-term use of anticholinergic medications, such as tricyclic antidepressants, and cognitive impairment, including dementia. Research suggests use of anticholinergics in older adult populations increases risk of dementia 30 to 50 percent.
Diabetic peripheral neuropathy, a syndrome which occurs when neurons are damaged and impairs neurological function in the extremities causing pain, numbness, susceptibility to infection and other complications, is relatively common among adults living with long-term or uncontrolled Type I or Type II diabetes. Current diabetes care guidelines include use of tricyclic antidepressants to manage pain and co-existing depression; however, these guidelines don’t describe the risks of long-term use of these drugs, which are intended to work in the nerves and brain.
“Using data from electronic health records, we found tricyclic antidepressants being prescribed to people with diabetes for periods of five years, sometimes up to eight or nine years, at a rate that puts about two thirds of tricyclic antidepressants users at higher risk of dementia,” said Dr. Campbell, an aging brain and pharmacy services researcher. “Deprescribing may modify risk for dementia and there are other options of medications not associated with cognitive impairment that may be as effective, but we found very, very little evidence of routine evaluation of drug efficacy occurring in the clinical care environment.
“Older Black adults in the U.S. are disproportionately diagnosed with dementia as compared to older White adults. Is it disease or is it medication they are taking? It’s difficult to modify disease but it’s within our control to modify the types of medicines that we are using to manage disease states.”
“Evaluation of Tricyclic Antidepressant Deprescribing in the Treatment of Diabetic Peripheral Neuropathy within Federally Qualified Health Centers” is published in Journal of the American Pharmacists Association.
This research project was funded by a 2022-2023 American Pharmacists Association Foundation Incentive Grant.
Authors and affiliations, as listed in the publication
Authors
Chelsea Herrarte1, Moises Martinez2, Jasmine D. Gonzalvo3, Brock T. Davis4, Lynn M. Thoma5, Noll L. Campbell6
Affiliations
1PGY-2 Ambulatory Care Pharmacy Resident, CommUnityCare Health Centers, Austin, TX; at time of study: PGY-1 Community-Based Pharmacy Resident, HealthLinc/Purdue University, Mishawaka, IN.
2Health Equity and Academic Administrative Fellow, Eskenazi/Purdue University, Indianapolis, IN.
3Clinical Professor at Purdue University College of Pharmacy, West Lafayette, IN.
4PGY-1 Community Pharmacy Residency Program Director, HealthLinc/Purdue University College of Pharmacy; Director of Clinical Pharmacy Services, HealthLinc, Mishawaka, IN; at time of study: Clinical Pharmacist Lead, HealthLinc, Mishawaka, IN.
5Senior Consultant, Visante, Valparaiso, IN; at time of study: PGY-1 Community Pharmacy Residency Program Director, HealthLinc/Purdue University College of Pharmacy; Director of Pharmacy, Valparaiso, IN.
6Associate Professor of Pharmacy Practice at Purdue University College of Pharmacy, West Lafayette, IN.
Noll Campbell, PharmD, M.S.
In addition to his role as a research scientist at Regenstrief Institute, Noll Campbell, PharmD, M.S., is an associate professor of pharmacy practice at Purdue University College of Pharmacy and an adjunct assistant professor of medicine at the Indiana University School of Medicine – Indianapolis. He is the president (June 2023-June 2024) of the American Delirium Society.
END
Study examines prescribing patterns of drug associated with cognitive impairment
Black older adults more likely to be prescribed these drugs at higher doses
2024-05-30
ELSE PRESS RELEASES FROM THIS DATE:
Cheap, dirty leftovers can produce pure oxygen
2024-05-30
New materials for producing oxygen may challenge traditional production methods. This is exciting news, because pure oxygen is in demand from many areas in industry and medicine.
“We have identified materials that can store and release pure oxygen much faster and at much lower temperatures than known materials currently used for this purpose,” says Professor Sverre Magnus Selbach at the Norwegian University of Science and Technology (NTNU’s) Department of Materials Science and Engineering.
Oxygen is an element, so it ...
Violence, aggression against educators grew post-pandemic
2024-05-30
While threats and violence against pre-K to 12th-grade teachers and other school personnel in the United States declined during the pandemic, after the restrictions were lifted, incidents rebounded to levels equal to or exceeding those prior to the pandemic, according to research published by the American Psychological Association.
As a result, the percentage of teachers expressing intentions to resign or transfer rose from 49% during the pandemic to 57% afterward, the researchers found.
“Aggression and violence against educators and school personnel are major concerns that affect the well-being of school personnel and the ...
Social media use and sleep duration connected to brain activity in teens
2024-05-30
DARIEN, IL – A new study to be presented at the SLEEP 2024 annual meeting found a distinct relationship between sleep duration, social media usage, and brain activation across brain regions that are key for executive control and reward processing.
Results show a correlation between shorter sleep duration and greater social media usage in teens. The analysis points to involvement of areas within the frontolimbic brain regions, such as the inferior and middle frontal gyri, in these relationships. ...
Study finds that better sleep is associated with lower loneliness
2024-05-30
DARIEN, IL – A new study to be presented at the SLEEP 2024 annual meeting found that better sleep health was associated with lower levels of loneliness, and this association was stronger among younger adults.
Results indicate that better sleep health was associated with significantly lower total loneliness, emotional loneliness and social loneliness. While better sleep health was associated with lower total and emotional loneliness across ages, this association was stronger for younger adults. However, age did not moderate the association ...
Novel vaccine concept generates immune responses that could produce multiple types of HIV broadly neutralizing antibodies
2024-05-30
WHAT:
Using a combination of cutting-edge immunologic technologies, researchers have successfully stimulated animals’ immune systems to induce rare precursor B cells of a class of HIV broadly neutralizing antibodies (bNAbs). The findings, published today in Nature Immunology, are an encouraging, incremental step in developing a preventive HIV vaccine.
HIV is genetically diverse making the virus difficult to target with a vaccine, but bNAbs may overcome that hurdle because they bind to parts of the virus that remain constant even when it mutates. ...
Study links sleep apnea treatment and happier, healthier relationships
2024-05-30
DARIEN, IL – A new study to be presented at the SLEEP 2024 annual meeting demonstrates that when individuals with obstructive sleep apnea use their positive airway pressure machine more regularly, it benefits their relationship with their partner.
Results show that greater adherence to PAP therapy was associated with higher levels of relationship satisfaction and lower levels of relationship conflict. Higher sleep efficiency among patients also was associated with higher levels of relationship satisfaction as reported by both the patient and their partner.
“Recognizing that sleep ...
Too much or too little: The impact of protein dosage on development
2024-05-30
New research from the University of Lausanne reveals that both the excess and the deficiency of a single protein can lead to severe intellectual deficiencies. The discovery offers critical insights for early diagnosis of a rare developmental disorder.
A team of scientists led by Alexandre Reymond, an expert in human genetics at the Center for Integrative Genomics (CIG) and professor at the Faculty of Biology and Medicine (FBM) of the University of Lausanne (UNIL), presents a major step forward in the detection of a rare genetic disease. For ...
Dana-Farber researchers uncover disparities in lived experiences for patients and physicians
2024-05-30
Boston – Four teams of Dana-Farber Cancer Institute investigators have found that people experience discrimination and bias in different ways and in more realms of cancer care than previously understood. The findings, in different studies, suggest that oncology professionals and the systems they work in have more work to do to adapt to the realities of increasing diversity and inclusion, not only in the patient population but also in the oncology workforce. The research teams will present their findings at the 2024 Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago. ASCO is the world’s largest clinical cancer ...
Mayo scientists developing at-home swab tests for endometrial, ovarian cancer
2024-05-30
ROCHESTER, Minnesota — Early detection improves treatment outcomes for endometrial and ovarian cancers, yet far too often women are diagnosed in advanced stages of these diseases. Unlike many other cancers, there are no standard screenings for early detection of endometrial and ovarian cancers. The incidence rate for endometrial cancer is expected to rise, driven by environmental factors, obesity and diabetes.
Marina Walther-Antonio, Ph.D., and colleagues at Mayo Clinic's Center for Individualized Medicine are on a mission to catch these cancers early.
Their research dives deep into the microbiome, a community of ...
UAB researchers uncover protein SRSF1’s uncommon ability to bind and unfold RNA G-quadruplexes
2024-05-30
BIRMINGHAM, Ala. – RNA transcription is the genomic process in which a cell produces a duplicate of a gene’s DNA sequence.
In a study published in Nucleic Acids Research, University of Alabama at Birmingham Department of Chemistry Professor Jun Zhang, Ph.D., and his team reveal how the protein SRSF1 possesses the novel function of binding and unfolding complex RNA Guanine-quadruplexes.
Present in both DNA and RNA sequences, a G-quadruplex (GQ) is a structure of four guanine bases attached in a planar array. ...
LAST 30 PRESS RELEASES:
Cancers grow uniformly throughout their mass
Researchers show complex relationship between Arctic warming and Arctic dust
Brain test shows that crabs process pain
Social fish with low status are so stressed out it impacts their brains
Predicting the weather: New meteorology estimation method aids building efficiency
Inside the ‘swat team’ – how insects react to virtual reality gaming
Oil spill still contaminating sensitive Mauritius mangroves three years on
Unmasking the voices of experience in healthcare studies
Pandemic raised food, housing insecurity in Oregon despite surge in spending
OU College of Medicine professor earns prestigious pancreatology award
Sub-Saharan Africa leads global HIV decline: Progress made but UNAIDS 2030 goals hang in balance, new IHME study finds
Popular diabetes and obesity drugs also protect kidneys, study shows
Stevens INI receives funding to expand research on the neural underpinnings of bipolar disorder
Protecting nature can safeguard cities from floods
NCSA receives honors in 2024 HPCwire Readers’ and Editors’ Choice Awards
Warning: Don’t miss Thanksgiving dinner, it’s more meaningful than you think
Expanding HPV vaccination to all adults aged 27-45 years unlikely to be cost-effective or efficient for HPV-related cancer prevention
Trauma care and mental health interventions training help family physicians prepare for times of war
Adapted nominal group technique effectively builds consensus on health care priorities for older adults
Single-visit first-trimester care with point-of-care ultrasound cuts emergency visits by 81% for non-miscarrying patients
Study reveals impact of trauma on health care professionals in Israel following 2023 terror attack
Primary care settings face barriers to screening for early detection of cognitive impairment
November/December Annals of Family Medicine Tip Sheet
Antibiotics initiated for suspected community-acquired pneumonia even when chest radiography results are negative
COVID-19 stay-at-home order increased reporting of food, housing, and other health-related social needs in Oregon
UW-led research links wildfire smoke exposure with increased dementia risk
Most U.S. adults surveyed trust store-bought turkey is free of contaminants, despite research finding fecal bacteria in ground turkey
New therapy from UI Health offers FDA-approved treatment option for brittle type 1 diabetes
Alzheimer's: A new strategy to prevent neurodegeneration
A clue to what lies beneath the bland surfaces of Uranus and Neptune
[Press-News.org] Study examines prescribing patterns of drug associated with cognitive impairmentBlack older adults more likely to be prescribed these drugs at higher doses