Inappropriate Drug Use in People with Cognitive Impairment and Dementia: A Systematic Review

Author(s): Kristina Johnell

Journal Name: Current Clinical Pharmacology
Continued as Current Reviews in Clinical and Experimental Pharmacology

Volume 10 , Issue 3 , 2015

Become EABM
Become Reviewer
Call for Editor


The aim of this systematic review was to identify, assess and summarize studies about potentially inappropriate drug use (IDU) in cognitive impairment and dementia and to present findings about whether cognitive impairment and dementia are associated with IDU. The search was made in Medline/PubMed using free terms in the title or abstract. The inclusion criteria were: English language, published until 1 March 2014, original quantitative study and assessment of overall IDU with a consensus based summarized measure. Exclusion criteria were: focus on specific patient group (other than cognitive impairment or dementia), focus on specific drug class and failure to present a prevalence measure of IDU or an effect estimate (i.e. odds ratio). Of the initial 182 studies found in Medline, 22 articles fulfilled the criteria. Most studies used the Beers criteria for assessment of IDU. Prevalence of IDU among individuals with cognitive impairment or dementia ranged from 10.2% to 56.4% and was higher in nursing home settings than in community-dwelling samples. Most studies reported a lower likelihood of IDU in case of cognitive impairment or dementia. To conclude, IDU is highly prevalent among persons with cognitive impairment and dementia, although these conditions seem to be associated with a lower probability of IDU. This might reflect an awareness among clinicians of cautious prescribing to this vulnerable group of patients. More studies on large cohorts of persons with cognitive impairment and dementia are needed to draw conclusions about optimal drug prescribing to this frail group of older persons.

Keywords: Cognitive impairment, dementia, inappropriate drug use, systematic review.

open access plus

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2015
Published on: 19 August, 2015
Page: [178 - 184]
Pages: 7
DOI: 10.2174/1574884710666150609154741

Article Metrics

PDF: 99
PRC: 2