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Kentucky, Yale, collaborate with U. of Sydney to study inappropriate medication use among people with dementia

Use of potentially inappropriate medications (PIM) among people with dementia is common. A multi-site team of investigators have assessed the patterns of medication use from 1-year before dementia diagnosis, to 1-year after dementia diagnosis, compared with patterns of medication use in people without dementia. Their results appear in The Journals of Gerontology.  

 

The investigators conducted longitudinal study using the National Alzheimer’s Coordinating Center data. Adults aged 65 years and older newly diagnosed with dementia (n= 2,418) during 2005–2015 were year, age, and sex matched 1:1 with controls. Generalized estimating equation models weighted for missingness and adjusted for 15 participant characteristics were fit.

 

Among participants with dementia, number of medications reported 1-year prediagnosis was 8% lower than at diagnosis year (p < .0001) and 11% higher 1-year postdiagnosis compared with year of diagnosis (p < .0001). Among participants with dementia, the odds of PIM exposure, assessed using the 2015 Beers Criteria, was 17% lower 1-year prediagnosis (p < .0001) and 17% higher 1-year postdiagnosis (p = .006) compared with year of diagnosis. Among controls, there were approximately 6% more medications reported between consecutive years (p < .0001 each comparison) and the odds of PIM exposure increased 11% between consecutive years (p = .006 and p = .047). At each annual follow-up, participants with dementia had lower odds of PIM exposure than their controls (prediagnosis p < .0001, at diagnosis p = .0007, postdiagnosis p = .03, respectively). There were no differences in exposure to anticholinergic medications.

 

Number of medications and PIM use increased annually for participants with and without dementia. Persistent challenge of increasing PIM use in this group of older adults is of major concern and warrants interventions to minimize such prescribing.

 

The lead author of the paper is Dr. Danijela Gnjidic, University of Sydney. Co-authors are Dr. Daniela C. Moga, University of Kentucky College of Public Health, UK College of Pharmacy, and the Sanders-Brown Center on Aging, and Dr. George Agogo, Dr. Christine Ramsey, and Dr. Heather Allore – all of Yale University.