Many older adults rely on medications to manage their health, but some drugs can have serious side effects, especially those that affect the brain.
These include medications like antipsychotics and benzodiazepines, which are often used to treat anxiety, sleep problems, or behavioral symptoms.
While they can be helpful in some situations, they may also cause confusion, increase the risk of falls, and even lead to hospitalization.
A new study from researchers at UCLA has found that these medications are often first prescribed in hospital settings rather than in regular doctor visits.
The findings were published in the journal JAMA Network Open.
The study focused on people aged 66 and older, many of whom already had some level of cognitive difficulty.
Cognitive impairment can range from mild memory problems to more serious conditions such as dementia. These individuals are especially vulnerable to the side effects of medications that affect the brain.
Researchers analyzed data collected over more than a decade, from 2008 to 2021. They used information from a large national study combined with Medicare records to track when and where patients first received prescriptions for certain types of drugs.
These drugs included antipsychotics, benzodiazepines, sleep medications, and anticholinergics, all of which can influence thinking and memory.
The results showed a clear pattern. A large number of these medications were first prescribed in acute care settings such as emergency rooms and hospitals, as well as in post-acute settings like nursing facilities. These settings accounted for a much higher share of prescriptions than expected based on how often patients visited them.
This was especially true for people with dementia. For example, nearly half of antipsychotic prescriptions for these patients were started in hospital or similar settings, even though only a smaller portion of their total healthcare visits occurred there.
This suggests that these environments may play a major role in starting treatments that continue long after the patient leaves.
Another important finding was that once these medications are started, they often continue for a long time. Many patients were still taking them a year later. This is concerning because long-term use can increase the risk of harmful side effects, particularly in older adults.
The study also found that people with more severe cognitive problems were more likely to receive these medications. About one in five patients with dementia received a new prescription in hospital or similar settings. This raises concerns about whether these medications are always necessary or if safer alternatives could be used.
The researchers believe their findings highlight an important opportunity for change. Efforts to reduce unnecessary or risky prescriptions may be most effective if they focus on hospitals and nursing facilities. These are the places where many of these medications are first introduced.
However, the study does have some limitations. The researchers assumed that the last healthcare setting a patient visited was where the prescription began, which may not always be accurate. Despite this, the large size of the study and the consistency of the findings make the results meaningful.
In conclusion, this research shows that where a medication is first prescribed can have a lasting impact on a patient’s health. Hospitals and similar settings appear to be key starting points for drugs that affect the brain, especially among older adults with cognitive problems.
By focusing on these settings, healthcare providers may be able to reduce unnecessary prescriptions and improve patient safety over time. More research is needed, but this study provides a clear direction for improving care.
If you care about dementia, please read studies about dietary strategies to ward off dementia, and how omega-3 fatty acids fuel your mind.
For more health information, please see recent studies about Choline deficiency linked to Alzheimer’s disease, and what to eat (and avoid) for dementia prevention.
