Some investigators have found that a history of a recent, fall was independently associated with involvement in an automobile crash, suggesting that both incidents could share risk factors.54 A number of retrospective and epidemiologic studies have found that, older drivers who used opioid analgesics and cyclic antidepressants had an increased risk for injurious motor vehicle
collisions without any evidence of dose-related effects.55 Conflicting results have been found for the benzodiazepines, with some investigators Inhibitors,research,lifescience,medical finding that the risk of crash involvement, is increased, while others finding that, it is not.55-57 While it, selleck inhibitor remains uncertain as to what degree drug-induced cognitive toxicity is involved in such discretely definable events as accidents, it is clear that the spectrum of cognitive impairment ranges from the more obvious presentations of delirium to the less
Inhibitors,research,lifescience,medical discernible deficits that can occur in reaction time, computational skill, symbol recognition, and memory. The latter may only be considered or identified outside formal clinical investigations when dramatic sequelae, such as a fail, occur. In addition, affective or behavioral toxicity may occur with manifestations such as depression or agitation. Inhibitors,research,lifescience,medical It is possible that these less severe cognitive manifestations also have a potentially substantial, though undoubtedly variable, effect, on activities of daily living and quality of life. Such consequences, however, are difficult to measure and even more difficult Inhibitors,research,lifescience,medical to relate to experimental tests of performance. Risk factors for developing drug-induced cognitive impairment As noted above, the risk of drug-related cognitive toxicity increases with the number of medications prescribed, and many older persons concurrently take numerous drugs as part of their medical regimens. However, there are also factors that are intrinsic to aging individuals that increase the likelihood of undesirable cognitive Inhibitors,research,lifescience,medical side effects. There is evidence that both neurotransmission
and signal transduction undergo changes during aging, leading to changes in regulation, sensitivity, and efficiency of the entire the neurotransmission process.25-27 Data suggest that there is probable reduced transmission in many systems, including the cholinergic, GABAergic (GABA, γ-aminobutyric acid), serotonergic, dopaminergic, and noradrenergic systems.58 Some data indicate that this may be due to loss of neurons or synapses, while other data indicate that, there is neuronal dysfunction.25,26 Loss of proteins that regulate synaptic plasticity has been documented both in the normal aging brain and in Alzheimer’s disease.27 Such alterations may render the older individual more vulnerable to drugs that further perturb these systems.