WASHINGTON (dpa-AFX) - According to research published in the medical journal JAMA, one in four Medicare patients with dementia is still prescribed brain-affecting drugs that can increase the risk of falls, confusion, and hospital stays.
'While CNS-active prescriptions may be appropriate in some cases, it is important for older patients or their caregivers to work closely with their physicians to ensure that these medications are appropriate to their cases. When inappropriate, patients and their care teams should consider alternative treatments and consider whether it might be safe to taper or stop the medication,' said lead author Dr. Annie Yang.
Researchers studied data from nearly 4,900 people in the Health and Retirement Study and linked it with Medicare records from 2013 to 2021. They looked at the use of certain brain-acting drugs that are often considered unsafe for older adults, including some antidepressants, antipsychotics, sleeping pills, anti-anxiety drugs, and barbiturates. The study also compared prescriptions among older adults with normal thinking, mild cognitive problems, and dementia.
They found that about 20 percent of patients received these potentially unsafe drugs in 2013, compared with 16 percent in 2021. Still, 25 percent of people with dementia were prescribed these drugs, compared with about 22 percent of those with cognitive impairment but no dementia, and 17 percent of those with normal brain function. The number of clearly inappropriate prescriptions also fell, from nearly 16 percent in 2013 to 11 percent in 2021. However, the researchers said there is still a lot of room for improvement. They found that more than two-thirds of patients had no clear medical reason recorded for receiving these medications, pointing to problems in how prescriptions are made.
'While this decline was encouraging, over two-thirds of patients receiving these prescriptions lacked a documented clinical indication in 2021, the end of the study period, suggesting high levels of potentially inappropriate and harmful prescribing,' said senior author Dr. John N. Mafi.
'Compared with patients with normal cognition, we also found higher levels of prescribing among older adults with cognitive impairment, who face a higher risk of adverse effects from these drugs. These results underscore substantial opportunities to improve the quality and safety of care for millions of older Americans.'
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