How a Dementia Diagnosis Relates to Medication Use

Are individuals diagnosed with dementia more likely to receive inappropriate medications? A recent study provides troubling evidence that the use of unnecessary medications increases following a diagnosis.

The University of Sydney study — conducted with the University of Kentucky and Yale University, and published in the Journals of Gerontology: Medical Sciences — followed almost 2,500 individuals and found that among those newly diagnosed with dementia, the use of medications increased by more than 10 percent within the following year. For potentially unnecessary or inappropriate medications, the increase was 17 percent over the year following diagnosis.

The study was not the first to find a higher rate of possibly inappropriate medication use among individuals with dementia. A 2014 study published in JAMA Internal Medicine found that more than half of individuals with advanced dementia residing in nursing homes were receiving at least one medication of questionable benefit.

Reasons for Inappropriate Medication Use

 The newer study listed the potentially inappropriate medications as drugs for pain and depression, proton pump inhibitors intended for acid reflux and sleeping pills. In most cases, the medications are intended for short-term use only, but the study authors noted they are commonly used over the longer term by individuals with dementia.

Th authors postulated that insufficient guidelines — as well as inadequate time for doctors to meet with individuals and advise them on medication use— might contribute to the problem. In addition, reduced ability to make decisions and problems with communication and understanding also may contribute to individuals with dementia taking the drugs inappropriately.

Potential Side Effects for Individuals with Dementia

Study authors expressed concern about their findings, which they said point to the importance of assessing the potential harm of administering unnecessary or inappropriate medications to individuals with dementia. Drowsiness, sedation and adverse events including falls, fractures and potential hospital stays are among the possible serious side effects, they noted.

The authors of the 2014 study cited high use of inappropriate or unnecessary medications among individuals with dementia who also were terminally ill. They stated that drugs for Alzheimer’s disease — often ineffective in individuals with severe dementia — were among the most-commonly administered drugs to individuals with advanced disease. In those cases, some individuals with advanced dementia experienced pain due to difficulty swallowing the medications and a high rate of clinical complications associated with the medications.

A Holistic Approach to Wellness

Authors of the recent study urged careful consideration of the outcomes for individuals with dementia who take potentially unnecessary medications. In addition to adhering to all established medical guidelines, Elder Care Alliance incorporates a holistic approach to wellness that honors the unique personality and needs of each individual. We agree with the study authors that additional research and interventions are required to eliminate any use of inappropriate medication among the global population of individuals with dementia.