2021 Fall GAPNA Newsletter Volume 40 Number 3

CNS-Active Drugs and Older Adults with Dementia

About 14% of older adults with dementia filled prescriptions for multiple medications that target the central nervous system (CNS), according to a recent study. Polypharmacy can increase the risk of serious side effects and lead to an increased risk of falling, breathing issues, and heart problems. In addition, some CNS-active drugs can affect thinking and memory, a side effect that is especially troubling in people with dementia.

In reviewing claims data on more than 1 million adults aged 77-88 with dementia, researchers found 13.9% filled prescriptions for three or more CNS-active drugs for more than 30 days in a row.

More than half of those adults had the drugs for more than 180 days. Researchers also found people who were prescribed a combination of CNS-active drugs had higher rates of insomnia, mental health conditions, and pain not associated with cancer and seizure disorders. However, researchers could not, based on the claims data, determine whether the drugs were prescribed to treat those conditions.

This study is the first to examine the number of adults with dementia who live in the community — not in nursing homes — and take a combination of CNS-active drugs. As the number of adults living with dementia increases, better understanding of how these drugs are used, their effects, and associated risks could help healthcare providers and patients with dementia make safer, well-informed care decisions.

Reference

Maust, D.T., Strominger, J., Kim, H.M., Langa, K.M., Bynum, J.P.W., Chang, C-H., … Marcus, S.C. (2021). Prevalence of central nervous system-active polypharmacy among older adults with dementia in the US. JAMA, 325(10), 952-961. https://doi.org/10.1001/jama.2021.1195