Effects of antipsychotic medications on older adults with dementia in Canadian complex and long-term care facilities / by Sarah Worobetz.

Abstract

Dementia is a neurodegenerative disease that involves progressive cognitive and functional decline. Symptoms vary and commonly include behaviour and psychological disturbances that can result in patients being prescribed antipsychotic medications. The use of these medications in managing the behavioural and psychological symptoms of dementia is controversial and have been the subject of numerous safety warnings. Research has consistently shown that high numbers of patients with dementia are still being prescribed antipsychotic medications despite these warnings and that there is a significantly higher rate of death for these individuals, compared to those who were not taking this type of medication. Through descriptive statistics and generalized linear mixed modelling this study aimed to show the nature of antipsychotic medication use in Canadian complex and long-term care facilities, as well the effects these medication have on various areas of functioning, health, and death rates in those with dementia. Approximately 40% of those diagnosed with dementia in Canadian care facilities are prescribed antipsychotic medications. Contrary to earlier studies, there was actually a slightly lower death rate for those individuals’ prescribed antipsychotic medications daily but a significantly higher death rate for those who were taking this form of medication inconsistently (1 to 6 days a week). These results suggest that there may be fundamental differences between the individuals receiving antipsychotic medications as a PRN and those who received them everyday, or that medical professionals and caregivers should ensure that patients with dementia consistently take antipsychotic medication, if required, rather than prescribing it on an as needed basis. Future research into the differences in death rate based on the frequency of antipsychotic medication use would be highly beneficial to confirm these findings, which contradict past research, to provide further insight into the safety of these medications for older adults with and without dementia.