Potential Link Between Regular Opioid Use and Increased Dementia Risk

Recent research published in Alzheimer's & Dementia reveals a significant association between consistent opioid use and a heightened risk of developing dementia, especially vascular dementia. Led by Dr. Sha Feng from the Shenzhen Institute of Advanced Technology and collaborating with experts from Massachusetts Veterans Home and the University of Pennsylvania, the study highlights critical insights into how opioids may influence cognitive health.

Chronic non-cancer pain (CNCP), a condition persisting for over three months unrelated to cancer, saw widespread opioid prescriptions starting in the mid-1990s. This increase has raised concerns over dependence, misuse, and potential neurological impacts. Existing evidence suggests that opioids can alter the brain's endogenous opioid system and impair regions such as the hippocampus, which are vital for cognitive function.

The study analyzed data from 197,673 UK Biobank participants aged between 37 and 73 years over an average follow-up period of nearly 14 years. Employing advanced statistical models to control for confounding factors, researchers found that individuals who regularly used opioids faced a 20% higher overall risk of developing dementia compared to non-opioid analgesic users. Those on high-potency opioids faced an even greater risk, exceeding 70%. Conversely, individuals taking non-opioid painkillers showed dementia risk comparable to those not using opioids.

Neuroimaging assessments further revealed that regular, strong opioid use was associated with reductions in total brain volume, white matter, and hippocampal size—regions crucial for memory and cognition. Additionally, regular opioid use was linked to decreased fluid intelligence, although no significant decline was observed in prospective memory.

These findings underscore the importance of evaluating opioid potency and cumulative exposure when considering risks related to cognitive decline. The research underscores the necessity for cautious opioid prescribing, especially for long-term pain management, to mitigate potential adverse effects on brain health.

Source: https://medicalxpress.com/news/2025-07-regular-opioid-dementia.html