Khaberni - Despite repeated medical warnings and clinical guidelines issued for years, one in four elderly dementia patients in the United States still receive medications that affect the brain, which are associated with an increased risk of falling, mental confusion, and hospitalization, according to a recent study from the University of California, Los Angeles (UCLA).
According to the study, published in JAMA journal, about 25% of Medicare beneficiaries with dementia were prescribed medications that affect the central nervous system, even though this group is most susceptible to serious side effects.
The data showed that the overall prescription rates of these medications among all elderly Medicare beneficiaries decreased from 20% in 2013 to 16% in 2021. However, this improvement was not sufficiently reflected in patients with cognitive impairment or dementia.
Dr. John Mafi, the lead researcher of the study and professor of internal medicine at the University of California, stated that "more than two-thirds of the patients who received these medications at the end of the study period didn't have a documented medical justification," indicating "concerning levels of inappropriate and potentially harmful prescriptions."
Medications associated with confusion and falls
The study included five main types of central nervous system-affecting drugs, including benzodiazepines, non-benzodiazepine sleep medications, antipsychotics, anticholinergic antidepressants, and barbiturates.
The results showed that these medications were prescribed to about 17% of elderly individuals with normal cognition, compared to 22% of those with cognitive impairment without dementia, and 25% of those with dementia.
Despite the decline in the prescription of some medications such as benzodiazepines and sleep medications over the past years, the prescription of antipsychotics saw a significant increase, which raises concerns among experts due to their association with increased mortality rates and complications in dementia patients.
Dr. Annie Yang, the co-researcher of the study, warned that these medications should only be necessary in limited cases, emphasizing the importance of regular treatment review, considering non-pharmaceutical alternatives, or gradually reducing doses when possible.
She added that patients or caregivers should work closely with physicians to assess whether the potential benefits outweigh the risks, especially among the elderly with cognitive disorders.
The researchers concluded that the study's findings highlight an urgent need to improve the safety and quality of healthcare provided to millions of elderly individuals with dementia, by reducing unnecessary prescriptions and promoting awareness of the risks associated with these medications.
