Imagine this: despite clear warnings from medical experts, one in four older adults with dementia is still being prescribed medications that could actually harm them. This shocking reality is backed by a new study set to publish on January 12 in the prestigious journal JAMA.
Here’s the unsettling part: these brain-altering drugs, linked to serious side effects like falls, confusion, and even hospitalization, are being given to a population that’s already vulnerable. But here’s where it gets controversial—while overall prescriptions for these medications dropped from 20% to 16% over nine years among Medicare beneficiaries, they’re still being handed out to those with dementia, who are at the highest risk.
Dr. John N. Mafi, a leading researcher from UCLA, points out that by 2021, over two-thirds of patients receiving these prescriptions had no clear medical reason for them. And this is the part most people miss—older adults with cognitive impairment, who are more susceptible to adverse effects, are actually prescribed these drugs at higher rates than those with normal cognition. This raises serious questions about the safety and quality of care for millions of seniors.
The study, which analyzed Medicare data from 2013 to 2021, focused on five classes of central nervous system (CNS)-active medications: antidepressants with strong anticholinergic properties, antipsychotics, barbiturates, benzodiazepines, and non-benzodiazepine hypnotics. While prescriptions for some drugs like benzodiazepines and sleep medications decreased, others, like antipsychotics, actually increased. Is this progress, or are we missing something?
Dr. Annie Yang, who led the study, emphasizes the need for patients and caregivers to work closely with doctors to ensure these medications are truly necessary. When they’re not, alternative treatments or tapering off the drugs should be considered. But the question remains: why are these potentially harmful prescriptions still so common?
Here’s a thought-provoking question for you: Are we prioritizing convenience over safety in prescribing these medications, or is there a deeper issue in how we approach dementia care? Share your thoughts in the comments—let’s spark a conversation that could lead to real change.
For those interested in diving deeper, the study’s findings are limited by missing data from Medicare Advantage plans and a focus on prescribing rates rather than long-term exposure. Still, the message is clear: we need to do better for our aging population. The research was funded by the National Institutes of Health/National Institute on Aging, and the full team of experts behind this study includes researchers from UCLA, Yale, RAND, and the University of Michigan.
