ArticleJournal of the American Geriatrics Society2023
Medication misuse and overuse in community-dwelling persons with dementia.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Trajectories of Medication Use Prior to Death in US Nursing Home Residents With Dementia.Journal of the American Medical Directors Association · 2026Article
- Falls and Fractures Among Medicare Beneficiaries Concurrently Receiving Anti-Dementia Drugs and Potentially Risky Medications.Medical care · 2025Article
- A Prospective Study on Potentially Inappropriate Drug Use and All-Cause Mortality in Community-Dwelling Older Adults.Journal of the American Geriatrics Society · 2025Article
- Household Wealth and Potentially Inappropriate Medications in Persons With Dementia: Role of Comorbidities and Caregivers.Journal of the American Geriatrics Society · 2025Article
- EVALUATION OF SCREENING TOOL OF OLDER PEOPLE'S PRESCRIPTIONS (STOPP) CRITERIA IN AN URBAN COHORT OF OLDER PEOPLE WITH HIV.Pharmacoepidemiology · 2025Article
- A longitudinal cohort study on dispensed analgesic and psychotropic medications in older adults before, during, and after the COVID-19 pandemic: the HUNT study.BMC geriatrics · 2025Observational
- Impact of Hospitalizations on Problematic Medication Use Among Community-Dwelling Persons With Dementia.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Exploring Concomitant Acetylcholinesterase Inhibitor and Overactive Bladder Anticholinergic Use and Risk of Hospitalization in Medicare and Dual-Eligible Medicare-Medicaid Populations in a Historic Database.Pharmacy (Basel, Switzerland) · 2023Article
- Examining Medical Interventions in Older Adults with Limited Life Expectancy-Opportunities and Challenges for De-implementation.Sage open agingReview
Corrections and comments
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Authors and funding
7 authors.
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Abstract
backgroundPersons with dementia (PWD) have high rates of polypharmacy. While previous studies have examined specific types of problematic medication use in PWD, we sought to characterize a broad spectrum of medication misuse and overuse among community-dwelling PWD.
methodsWe included community-dwelling adults aged ≥66 in the Health and Retirement Study from 2008 to 2018 linked to Medicare and classified as having dementia using a validated algorithm. Medication usage was ascertained over the 1-year prior to an HRS interview date. Potentially problematic medications were identified by: (1) medication overuse including over-aggressive treatment of diabetes/hypertension (e.g., insulin/sulfonylurea with hemoglobin A1c < 7.5%) and medications inappropriate near end of life based on STOPPFrail and (2) medication misuse including medications that negatively affect cognition and medications from 2019 Beers and STOPP Version 2 criteria. To contextualize, we compared medication use to people without dementia through a propensity-matched cohort by age, sex, comorbidities, and interview year. We applied survey weights to make our results nationally representative.
resultsAmong 1441 PWD, median age was 84 (interquartile range = 78-89), 67% female, and 14% Black. Overall, 73% of PWD were prescribed ≥1 potentially problematic medication with a mean of 2.09 per individual in the prior year. This was notable across several domains, including 41% prescribed ≥1 medication that negatively affects cognition. Frequently problematic medications included proton pump inhibitors (PPIs), non-steroidal anti-inflammatory drugs (NSAIDs), opioids, antihypertensives, and antidiabetic agents. Problematic medication use was higher among PWD compared to those without dementia with 73% versus 67% prescribed ≥1 problematic medication (p = 0.002) and mean of 2.09 versus 1.62 (p < 0.001), respectively.
conclusionCommunity-dwelling PWD frequently receive problematic medications across multiple domains and at higher frequencies compared to those without dementia. Deprescribing efforts for PWD should focus not only on potentially harmful central nervous system-active medications but also on other classes such as PPIs and NSAIDs.
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