CNS-Active Meds Often Prescribed for Older Adults With Dementia

WEDNESDAY, Aug. 19, 2020 (HealthDay News) — Patients with dementia are frequently prescribed central nervous system (CNS)-active medications, according to a research letter published online Aug. 18 in the Journal of the American Medical Association.

Donovan T. Maust, M.D., from the University of Michigan in Ann Arbor, and colleagues identified CNS-active medication prescriptions among fee-for-service Medicare beneficiaries aged 65 years or older with a primary or secondary diagnosis of dementia.

The researchers found that 73.5 percent of the 737,839 community-dwelling beneficiaries with dementia were prescribed any CNS-active medication. The prevalence of any prescription fill was higher for women, those aged 65 to 74 years, non-Hispanic whites, and low-income individuals (75.3, 80.6, 74.6, and 76.5 percent, respectively). Overall, 49.8, 29.8, 26.8, 21.9, and 21.6 percent filled an antidepressant prescription, an opioid, anxiolytics, antiepileptics, and antipsychotics, respectively. For individual drug classes, the associations between demographics and prescription fills were generally consistent in direction and were higher among women, younger adults (aged 65 to 74 years), non-Hispanic whites, and low-income older adults. Mixed associations were seen for rurality with prescription fills. The top opioid medications filled were hydrocodone and tramadol (13.5 and 12.1 percent, respectively). Per-person volumes for both were relatively low.

“Prescribing of CNS-active medications to community-dwelling Medicare beneficiaries with dementia was frequent, raising concerns about the risk-benefit balance,” the authors write. “Work is needed to understand factors driving prescribing given scant evidence of benefit for adults with dementia.”

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