
Photo Credit: Wikimedia Commons
Scientific Frontline: "At a Glance" Summary
- Main Discovery: One in four Medicare beneficiaries with dementia is prescribed central nervous system (CNS)-active medications—such as sedatives and antipsychotics—despite clinical guidelines warning against their use due to risks of falls, confusion, and hospitalization.
- Methodology: Researchers analyzed survey data from the Health and Retirement Study linked to Medicare fee-for-service claims from 2013 to 2021 to trace prescribing patterns of five drug classes across adults with normal cognition, cognitive impairment, and dementia.
- Data Stratification: Prescribing prevalence was highest among the most vulnerable: 25% of patients with dementia and nearly 22% of those with cognitive impairment received these drugs, compared to 17% of older adults with normal cognition.
- Specific Trends: While overall CNS-active prescriptions decreased from 20% to 16% over the study period (driven by declines in benzodiazepines and hypnotics), antipsychotic prescriptions conversely rose from 2.6% to 3.6%.
- Clinical Validity: In 2021, over two-thirds of patients receiving these prescriptions lacked a documented clinical indication, suggesting a high volume of potentially inappropriate and harmful prescribing practices.
- Significance: These findings highlight substantial opportunities to improve safety for cognitively impaired older adults, necessitating rigorous medication reviews by physicians to taper or discontinue inappropriate treatments.


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