Certain medication classes are associated with an increased risk of poor road performance over time in cognitively healthy older adults, according to a prospective cohort study. “[These findings] suggest that physicians and pharmacists should be aware of potential driving risks in older drivers who are prescribed psychotropic drugs and pain medications and provide consultation accordingly,” the authors conclude.
Among participants in the Knight Alzheimer’s Disease Research Center in St. Louis, Missouri, and nearby Illinois suburbs, those with driver’s licenses were included in the prospective cohort study in 2012–2023. Effects of specific medication classes (ie, antidepressants, benzodiazepines, sedatives or hypnotics, anticholinergics, antihistamines, and NSIADs or acetaminophen) were considered using a primary outcome measure of performance on the Washington University Road Test (pass or marginal/fail).
“Of the 198 included adults (mean [SD] baseline age, 72.6 [4.6] years; 87 female [43.9%]), 70 (35%) received a marginal/fail rating on the road test over a mean (SD) follow-up of 5.70 (2.45) years,” report the authors. “Any use of antidepressants (adjusted hazard ratio [aHR], 2.68; 95% CI, 1.69-4.71), serotonin and norepinephrine reuptake inhibitors (aHR, 2.68; 95% CI, 1.54-4.64), sedatives or hypnotics (aHR, 2.70; 95% CI, 1.40-5.19), or nonsteroidal anti-inflammatory drugs (aHR, 2.72; 95% CI, 1.31-5.63) was associated with an increase in risk of receiving a marginal/fail rating on the road test compared with control individuals. Conversely, participants taking lipid-lowering agents had a lower risk of receiving a marginal/fail rating compared to control individuals. There were no statistically significant associations found between anticholinergic or antihistamines and poor performance.”