Longitudinal patterns of potentially inappropriate medication use following incident dementia diagnosis

Abstract

IntroductionPotentially inappropriate medication (PIM) use in older adults with dementia is an understudied area. We assessed longitudinal changes in PIM exposure by dementia type following dementia diagnosis. MethodsWe followed 2448 participants aged ≥65 years (52% women, 85.5% Caucasian, mean age 80.9 ± 7.5 years) diagnosed with dementia after enrollment in the National Alzheimer's Coordinating Center (2005–2014). We estimated the association between dementia type and PIM annually for 2 years after diagnosis, using Generalized Estimating Equations. ResultsParticipants with Lewy body dementia had more PIM use, and participants with frontotemporal dementia had less PIM use than participants with Alzheimer's disease. In the first year following diagnosis, total number of medications increased, on average, by 10% for Alzheimer's disease and 15% for Lewy body dementia (P < .05 for both). DiscussionA tailored approach aimed at optimizing drug therapy is needed to mitigate PIM exposure to improve medical care for individuals with dementia.