Millions of older adults with dementia continue to be prescribed drugs linked to falls and confusion, despite long-standing warnings. A recent study, highlighted by ScienceDaily on January 13, 2026, found one in four Medicare beneficiaries with dementia still receive these potentially harmful medications. Often lacking medical justification, this situation underscores persistent dementia medication risks for a vulnerable population.
This alarming trend underscores a critical gap in patient safety for a population already vulnerable to cognitive decline. The research, published in JAMA and conducted by UCLA Health Sciences, analyzed prescribing patterns from 2013 to 2021.
The study revealed individuals with cognitive impairment consistently face higher rates of these prescriptions. These findings question the efficacy of current guidelines and the practical implementation of safer care practices, especially concerning dementia medication risks.
The study tracked the use of central nervous system (CNS)-active medications: antidepressants with strong anticholinergic properties, antipsychotics, barbiturates, benzodiazepines, and non-benzodiazepine hypnotics. All are known for their potential to exacerbate symptoms in sensitive patients.
Prevalence of dementia medication risks and prescribing patterns
Despite an overall national decline in CNS-active medication prescribing across the Medicare population, a significant disparity remains for individuals with dementia. The study reported a drop from 20% to 16% in overall usage over the nine-year period. However, for those with dementia, approximately 25% were still receiving these drugs in 2021.
This compares to 17% of older adults with normal cognition and nearly 22% of those with cognitive impairment but no dementia. Dr. John N. Mafi, associate professor-in-residence of medicine at UCLA, highlighted the lack of justification.
“While this decline was encouraging, over two-thirds of patients receiving these prescriptions lacked a documented clinical indication in 2021,” Dr. Mafi stated, suggesting high levels of potentially inappropriate prescribing. This persistent issue elevates dementia medication risks for a fragile group.
Specific medication types showed varied trends. While benzodiazepines and non-benzodiazepine hypnotics saw declines, antipsychotic prescriptions actually increased from 2.6% to 3.6% during the study period. Anticholinergic antidepressants remained steady, indicating persistent problematic prescribing.
Addressing inappropriate prescribing and future directions
The continued high rates of potentially inappropriate prescriptions for dementia patients highlight the urgent need for enhanced clinical vigilance and improved adherence to existing guidelines. Many healthcare providers balance symptom management with minimizing adverse effects, especially for challenging behaviors associated with dementia.
However, the study points to a substantial portion of these prescriptions lacking clear clinical justification. Efforts to reduce inappropriate prescribing must focus on comprehensive medication reviews, patient-centered care planning, and robust educational initiatives for clinicians.
Organizations like the American Geriatrics Society provide guidelines, such as the Beers Criteria, which identify potentially inappropriate medications for older adults. Integrating these tools more effectively into clinical practice could mitigate dementia medication risks.
Furthermore, exploring non-pharmacological interventions for behavioral symptoms in dementia could offer safer alternatives, reducing reliance on drugs with significant side effects. The study’s limitations, such as not including Medicare Advantage data, suggest the true scope of the problem may be larger.
The persistent prescribing of potentially harmful medications to millions with dementia is a stark reminder of ongoing challenges in geriatric care. While some progress has been made, the disproportionate rates among dementia patients, often without documented clinical need, demand immediate attention.
Moving forward, collaborative efforts between patients, caregivers, and physicians are paramount to ensuring medication appropriateness. Resources from the National Institute on Aging can support informed decisions. Prioritizing the safety and quality of life for those living with cognitive impairment is essential. This collective commitment is crucial to truly diminish dementia medication risks.
