Medications causing potential cognitive impairment are common in nursing home dementia units – A cross-sectional study
Hansen Kristensson, Jenny ; Zahirovic, Iris LU ; Londos, Elisabet LU and Modig, Sara LU
(2021)
In Exploratory Research in Clinical and Social Pharmacy
3.
- Abstract
- Background
With advancing age the brain becomes more sensitive to centrally acting drugs thus increasing the risk of cognitive side-effects. The Swedish National Board of Health and Welfare developed indicators to measure and follow quality in older people's drug therapy, one being “Potentially Inappropriate Medications risking Cognitive impairment (PIMcogn)”. Associations between anticholinergics and cognitive impairment are described, especially in persons with Alzheimer's disease or Lewy Body Dementia/Parkinson's disease dementia, due to degenerated cholinergic pathways.
Objectives
To examine the prevalence of PIMcogn and if it differed between nursing home residents with and without a dementia diagnosis and between... (More) - Background
With advancing age the brain becomes more sensitive to centrally acting drugs thus increasing the risk of cognitive side-effects. The Swedish National Board of Health and Welfare developed indicators to measure and follow quality in older people's drug therapy, one being “Potentially Inappropriate Medications risking Cognitive impairment (PIMcogn)”. Associations between anticholinergics and cognitive impairment are described, especially in persons with Alzheimer's disease or Lewy Body Dementia/Parkinson's disease dementia, due to degenerated cholinergic pathways.
Objectives
To examine the prevalence of PIMcogn and if it differed between nursing home residents with and without a dementia diagnosis and between residents with different dementia aetiologias.
Methods
Descriptive cross-sectional study, based on residents ≥65 years in nursing home dementia units in Malmö, Sweden, in 2012–2013 (N = 574).
Results
The study population consisted of 76% women, the mean age was 86 years and a dementia diagnosis was registered in 92%. A total of 74% were prescribed at least one PIMcogn. Benzodiazepines were prevalent in 59%, opioids in 27%, antipsychotics in 20% and anticholinergics in 13%. Opioids used regularly and antiepileptics were more common in residents without a dementia diagnosis. The lowest proportion of anticholinergics was seen in the oldest age group, 11.0%. There was no difference seen in anticholinergics between dementia types with considerable cholinergic deficit and other dementia diagnoses.
Conclusions
Treatment with at least one PIMcogn was common. Usage of benzodiazepines and antipsychotics was, despite the knowledge of alarming side-effects, high.
An awareness of the inappropriateness in prescribing anticholinergics to the oldest old seems to be apparent, but not to persons with cholinergic deficit. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/ce93db00-9a30-422e-9d14-4550aef1fed6
- author
- Hansen Kristensson, Jenny
; Zahirovic, Iris
LU
; Londos, Elisabet
LU
and Modig, Sara
LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Exploratory Research in Clinical and Social Pharmacy
- volume
- 3
- article number
- 100054
- publisher
- Elsevier
- external identifiers
-
- pmid:35480606
- scopus:85143914920
- ISSN
- 2667-2766
- DOI
- 10.1016/j.rcsop.2021.100054
- language
- English
- LU publication?
- yes
- id
- ce93db00-9a30-422e-9d14-4550aef1fed6
- date added to LUP
- 2021-10-19 14:35:16
- date last changed
- 2024-06-15 00:24:58
@article{ce93db00-9a30-422e-9d14-4550aef1fed6,
abstract = {{Background<br/>With advancing age the brain becomes more sensitive to centrally acting drugs thus increasing the risk of cognitive side-effects. The Swedish National Board of Health and Welfare developed indicators to measure and follow quality in older people's drug therapy, one being “Potentially Inappropriate Medications risking Cognitive impairment (PIMcogn)”. Associations between anticholinergics and cognitive impairment are described, especially in persons with Alzheimer's disease or Lewy Body Dementia/Parkinson's disease dementia, due to degenerated cholinergic pathways.<br/>Objectives<br/>To examine the prevalence of PIMcogn and if it differed between nursing home residents with and without a dementia diagnosis and between residents with different dementia aetiologias.<br/>Methods<br/>Descriptive cross-sectional study, based on residents ≥65 years in nursing home dementia units in Malmö, Sweden, in 2012–2013 (N = 574).<br/>Results<br/>The study population consisted of 76% women, the mean age was 86 years and a dementia diagnosis was registered in 92%. A total of 74% were prescribed at least one PIMcogn. Benzodiazepines were prevalent in 59%, opioids in 27%, antipsychotics in 20% and anticholinergics in 13%. Opioids used regularly and antiepileptics were more common in residents without a dementia diagnosis. The lowest proportion of anticholinergics was seen in the oldest age group, 11.0%. There was no difference seen in anticholinergics between dementia types with considerable cholinergic deficit and other dementia diagnoses.<br/>Conclusions<br/>Treatment with at least one PIMcogn was common. Usage of benzodiazepines and antipsychotics was, despite the knowledge of alarming side-effects, high.<br/><br/>An awareness of the inappropriateness in prescribing anticholinergics to the oldest old seems to be apparent, but not to persons with cholinergic deficit.}},
author = {{Hansen Kristensson, Jenny and Zahirovic, Iris and Londos, Elisabet and Modig, Sara}},
issn = {{2667-2766}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{Exploratory Research in Clinical and Social Pharmacy}},
title = {{Medications causing potential cognitive impairment are common in nursing home dementia units – A cross-sectional study}},
url = {{http://dx.doi.org/10.1016/j.rcsop.2021.100054}},
doi = {{10.1016/j.rcsop.2021.100054}},
volume = {{3}},
year = {{2021}},
}