A narrative review of problems with medicines use in people with dementia

Expert Opin Drug Saf. 2018 Aug;17(8):825-836. doi: 10.1080/14740338.2018.1497156. Epub 2018 Jul 19.

Abstract

Introduction: People with dementia may be particularly susceptible to medication-related problems for various reasons. They include progressive cognitive decline, high sensitivity to the effect of medications on cognition and memory, and increased likelihood of comorbidities.

Areas covered: This paper aimed to review current literature on the frequency and the types of medication-related problems, and their contribution to hospital admission in people with dementia. Literature searches were conducted using key search terms of dementia and medication-related problems. Studies investigating any medication-related problems in people with dementia or cognitive impairment were included.

Expert opinion: Previous research showed a high prevalence of medication-related problems in people with dementia. However, no single category of medication-related problems was reported consistently as the most frequent type across studies. The available studies also showed that medication-related hospitalization was common among people with dementia. These findings underline the need for effective medication management services to reduce the risk of these problems in people with dementia and cognitive impairment. Further work is required to characterize medication-related problems comprehensively in this vulnerable patient group across settings of care. Future research should take a holistic approach in the identification of medication-related problems.

Keywords: Adverse drug reactions; dementia; hospitalization; medication adherence; medication safety; medication-related problems; potentially inappropriate prescribing.

Publication types

  • Review

MeSH terms

  • Cognition Disorders / complications
  • Cognition Disorders / physiopathology*
  • Dementia / complications
  • Dementia / physiopathology*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Medication Therapy Management / organization & administration
  • Prevalence
  • Risk