The Impact of Dementia Diagnosis on Patterns of Potentially Inappropriate Medication Use among Older Adults

Danijela Gnjidic, George O. Agogo, Christine M. Ramsey, Daniela C. Moga, Heather Allore

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24 Citations (SciVal)


Background Use of potentially inappropriate medications (PIM) among people with dementia is common. We assessed the patterns of medication use from 1-year before dementia diagnosis, to 1-year after dementia diagnosis, compared with patterns of medication use in people without dementia. Methods We conducted longitudinal study using the National Alzheimer's Coordinating Center data. Adults aged 65 years and older newly diagnosed with dementia (n = 2,418) during 2005-2015 were year, age, and sex matched 1:1 with controls. Generalized estimating equation models weighted for missingness and adjusted for 15 participant characteristics were fit. Results Among participants with dementia, number of medications reported 1-year prediagnosis was 8% lower than at diagnosis year (p <.0001) and 11% higher 1-year postdiagnosis compared with year of diagnosis (p <.0001). Among participants with dementia, the odds of PIM exposure, assessed using the 2015 Beers Criteria, was 17% lower 1-year prediagnosis (p <.0001) and 17% higher 1-year postdiagnosis (p =.006) compared with year of diagnosis. Among controls, there were approximately 6% more medications reported between consecutive years (p <.0001 each comparison) and the odds of PIM exposure increased 11% between consecutive years (p =.006 and p =.047). At each annual follow-up, participants with dementia had lower odds of PIM exposure than their controls (prediagnosis p <.0001, at diagnosis p =.0007, postdiagnosis p =.03, respectively). There were no differences in exposure to anticholinergic medications. Conclusions Number of medications and PIM use increased annually for participants with and without dementia. Persistent challenge of increasing PIM use in this group of older adults is of major concern and warrants interventions to minimize such prescribing.

Original languageEnglish
Pages (from-to)1410-1417
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number10
StatePublished - Sep 11 2018

Bibliographical note

Funding Information:
This work was supported by grants (R01 AG054130 DM, R01 AG047891 to H.A., G.O.A.) and by the Yale Pepper Center (P30 AG021342, P30 AG021342 H.A., G.O.A.), Yale Alzheimer’s Disease Research Center, Data Management and Statistics Core (P50 AG047270 H.A.,  C.M.R.) all from the National Institutes of Health/National Institute on Aging. D.G.  is supported by the Australian National Health Medical Research Council Dementia Leadership Fellowship (1136849) and International Profile Development Fund grant, University of Sydney.

Funding Information:
The NACC database is funded by NIA/NIH Grant U01 AG016976. NACC data are contributed by the NIA-funded ADCs: P30 AG019610 (PI Eric Reiman, MD), P30 AG013846 (PI Neil Kowall, MD), P50 AG008702 (PI Scott Small, MD), P50 AG025688 (PI Allan Levey, MD, PhD), P50 AG047266 (PI Todd Golde, MD, PhD), P30 AG010133 (PI Andrew Saykin, PsyD), P50 AG005146 (PI Marilyn Albert, PhD), P50 AG005134 (PI Bradley Hyman, MD, PhD), P50 AG016574 (PI Ronald Petersen, MD, PhD), P50 AG005138 (PI Mary Sano, PhD), P30 AG008051 (PI Thomas Wisniewski, MD), P30 AG013854 (PI M.  Marsel Mesulam, MD), P30 AG008017 (PI Jeffrey Kaye, MD), P30 AG010161 (PI David Bennett, MD), P50 AG047366 (PI Victor Henderson, MD, MS), P30 AG010129 (PI Charles DeCarli, MD), P50 AG016573 (PI Frank LaFerla, PhD), P50 AG005131 (PI James Brewer, MD, PhD), P50 AG023501 (PI Bruce Miller, MD), P30 AG035982 (PI Russell Swerdlow, MD), P30 AG028383 (PI Linda Van Eldik, PhD), P30 AG053760 (PI Henry Paulson, MD, PhD), P30 AG010124 (PI John Trojanowski, MD, PhD), P50 AG005133 (PI Oscar Lopez, MD), P50 AG005142 (PI Helena Chui, MD), P30 AG012300 (PI Roger Rosenberg, MD), P30 AG049638 (PI Suzanne Craft, PhD), P50 AG005136 (PI Thomas Grabowski, MD), P50 AG033514 (PI Sanjay Asthana, MD, FRCP), P50 AG005681 (PI John Morris, MD), P50 AG047270 (PI Stephen Strittmatter, MD, PhD).

Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.


  • Dementia diagnosis
  • Generalized estimating equations
  • Medications
  • Potentially inappropriate medications (PIM)
  • Weighting for missingness

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


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