Beneficiaries with cognitive impairment and those with dementia were more likely to receive these prescriptions than those with normal cognition
WEDNESDAY, Jan. 21, 2026 (HealthDay News) — Many older adults receive potentially inappropriate central nervous system (CNS)-active medications, according to a research letter published online Jan. 12 in the Journal of the American Medical Association.
Annie W. Yang, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues examined prescribing patterns of potentially inappropriate CNS-active medications among adults 65 years or older with and without cognitive impairment no dementia (CIND) and dementia from 2013 to 2021 using the Health and Retirement Study linked to Medicare fee-for-service claims.
A total of 4,842 participants were identified from 2013 to 2021. The researchers found that in 2013, 19.9 percent of beneficiaries received one or more potentially inappropriate CNS-active prescriptions, declining to 16.2 percent in 2021 in adjusted analyses. Beneficiaries with CIND and dementia were more likely to receive these prescriptions compared with those with normal cognition (21.7 and 25.1, respectively, versus 17.0 percent). Benzodiazepine and nonbenzodiazepine hypnotic prescribing decreased between 2013 and 2021. The prescribing rates for antipsychotics, antidepressants, and barbiturates did not differ significantly in 2013 and 2021. No significant difference was seen between 2013 and 2021 in prescriptions with clinical indications; potentially inappropriate prescriptions without clinical indications decreased between 2013 and 2021. Overall, 11.4 percent of the beneficiaries receiving potentially inappropriate CNS-active prescriptions in 2021 lacked clinical indications.
“While CNS-active prescriptions may be appropriate in some cases, it is important for older patients or their caregivers to work closely with their physicians to ensure that these medications are appropriate to their cases,” Yang said in a statement.
Several authors disclosed ties to the biopharmaceutical and health insurance industries.
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