People with Alzheimer’s Often Take Unnecessary Medications

An elderly woman gazes out the windowPerhaps the most frightening thing about an Alzheimer’s diagnosis is that there is not yet a cure for the disease. While people with Alzheimer’s may take medications to slow the progression of the disease or reduce symptoms, the effectiveness of these medications is frequently lower among people with advanced-stage Alzheimer’s. According to a new study, 54% of people with late-stage Alzheimer’s take at least one unnecessary drug, potentially leading to unpleasant side effects and driving up the costs of health care.

Unnecessary Use of Medication

Researchers evaluated the medical records of 5,406 people living in 460 nursing homes. All of the study participants had advanced-stage dementia. The residents regularly failed to recognize family members, typically had a vocabulary of five or fewer words, and most of them could no longer walk. They found that more than half of study participants took at least one medication of questionable benefit. Drugs to treat dementia and cholesterol-lowering medications were the most common.

People who lived in a facility with a high use of feeding tubes were more likely to take unnecessary medications, whereas those who had a do-not-resuscitate order, who enrolled in hospice care, who had eating difficulties, or who were on a feeding tube were less likely to be prescribed unnecessary medications.

The study’s authors note that clinical inertia—the tendency to stick with something even when it’s no longer working—contributes to this phenomenon. While a few extra pills that offer no benefit might not seem like a serious issue for a very ill person, unnecessary medications can cause problems. Many of the people in the study had difficulty swallowing pills, making medication time a needless source of stress. The limited vocabulary of the study participants also means that they were unable to communicate about the unpleasant side effects, such as urinary pain or nausea, to their care providers.

Medication is a significant driver of medical costs. The study found that the average 90-day expenditure on needless medication was $816 and that these medications accounted for more than a third of the total money spent on medication.

References:

Tjia, J., Peterson, D., Liu, Q., Andrade, S. E., & Mitchell, S. L. (2014). Use of medications of questionable benefit in advanced stage dementia. Jama Internal Medicine. doi: 10.1001/jamainternmed.2014.4103

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  • Burke

    Burke

    September 18th, 2014 at 10:27 AM

    This is so sad and to think that people wonder what keeps driving our medical costs further and further up!
    It is suppsoed “care” like this when patients are given things that they don’t even need

  • lorie

    lorie

    September 18th, 2014 at 4:23 PM

    But these places won’t do any of this unless it is specifically ordered by a doctor… have we considered that te problem may well lie with a provider who is simply trying to get by with the patient and the family and not make any waves? Sometimes people come in and they have this problem and that problem and even though we know that this is not something that can be remedied with a prescription, you give them something because the mindset is that they need medication to make things better. There are numerous end of life challenges that have to be confronted that’s for sure.

  • abra

    abra

    September 19th, 2014 at 4:32 AM

    Are we talking drugs that are supposed to be for Alzheimer’s which are not working or are we talking about pills for other conditions? I was a little unclear on that

  • Dillon

    Dillon

    September 19th, 2014 at 10:28 AM

    I hope that facilities such as this understand that it is reports such as this that really do give them a bad name, sometimes unwarranted but sometimes very much so. You cannot just drug the people who live there and expect that everyone will think that this is okay. These are still living thriving people that we are talking about here, and to treat them as anything less than that is unacceptable. I know that may times the families seem to disappearn and there are questions that they have a hard time getitng answered but I think that many times this is elder abuse, should be recognized as such and they should face punishment for it if this is proven to be true.

  • eugenia

    eugenia

    September 23rd, 2014 at 11:03 AM

    Such a serious issue in that taking medications which are unnecessary do nothing to help one’s health. I am also quite dismayed that this is happening to a segment of the population which really does not have a voice where they can speak up for themselves, that they cannot articulate when something could be wrong. I am saddened by the whole thing actually.

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