Approximately 190 000 people in Australia were estimated to have dementia in 2006, with the prevalence expected to increase to 465 000 by 2031.1 The prevalence of dementia increases with age, from 6.5% of Australians aged 65 years and over to 22% of Australians aged 85 years and over.2 Dementia is associated with a large burden of disease in Australia’s aging population, costing Australia $1.4 billion in 2003.2 Most of this burden was associated with residential aged care facilities (RACFs).2 Dementia is the medical problem most frequently managed by general practitioners attending RACFs.3 Ninety-six percent of people with dementia living in care accommodation in Australia have moderate or severe dementia, compared to only 7% of people with dementia living in households.1 Therefore people requiring residential care tend to be among the frailest and sickest in the community, with substantial physical and behavioural needs and multiple comorbidities.
Older people are more likely to be
exposed to polypharmacy. People
with dementia, especially those living
in residential aged care facilities
(RACFs), are at particularly high risk of
medication harm. We sought to describe
medications prescribed for a sample of
people with dementia living in RACFs.
A total of 351 residents with dementia
aged over 65 years were recruited
from 36 RACFs in Western Australia.
Data on all medications prescribed
were collected, including conventional
medications, herbal medications,
vitamins and minerals.
Polypharmacy was identified in
91.2% (average 9.75 medications per
person); one-third were prescribed an
antipsychotic medication; and 50.4%
were found to be taking at least one
potentially inappropriate medication.
The combination of antipsychotics and
antidepressants was the most frequently
observed drug-drug interaction, being
prescribed to 15.7% of participants.
People with dementia living in RACFs are
commonly exposed to polypharmacy.
Prescription of contraindicated
medications, antipsychotics, medications
with high anticholinergic burden, and
combinations of potentially inappropriate
mediations is also common. There
may be substantial scope to improve
prescribing for older people with
dementia living in RACFs.
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