TOPLINE

Exposure to potentially inappropriate medications for cognitive indications among older adults declined from 2011 to 2022. Exposure to these inappropriate medications was associated with higher odds of poor mental quality of life and increased rates of emergency department visits and hospitalizations.

METHODOLOGY

• Researchers conducted a cross-sectional analysis using data from a nationally representative survey from 2011 to 2022.
• They identified more than 2700 older adults aged 65 years or older with cognitive disorders, representing a weighted analytic sample of approximately 29.7 million individuals.
• Exposure to potentially inappropriate medications with adverse cognitive effects was defined as at least one filled prescription for anticholinergics, antipsychotics, benzodiazepines, or hypnotics during the calendar year.
• Outcomes assessed were the annual prevalence of exposure to cognitive potentially inappropriate medications, physical and mental quality of life, hospitalizations, and emergency department and outpatient visits.

TAKEAWAY

• Overall exposure to cognitive potentially inappropriate medications declined from 39.3% in 2011 to 29.3% in 2022 with an annual percentage change (APC) of -1.9%.
• Benzodiazepines and nonbenzodiazepine hypnotics showed a significant decline (APC, -6.8%; P < .01 and APC, -10.6%; P < .01; respectively).
• Exposure to cognitive potentially inappropriate medications was associated with higher odds for poor mental health-related quality of life (adjusted odds ratio [aOR], 1.72; P < .01), with non-benzodiazepine hypnotics showing the largest effect (aOR, 2.47; P = .01).
• Exposure to inappropriate medications was associated with higher rates of emergency department visits (adjusted incidence rate ratio [aIRR], 1.41; P < .01) and hospitalizations (aIRR, 1.38; P < .01) but not with outpatient visits.

IN PRACTICE

“[The] findings suggest that cognitive potentially inappropriate medication exposure may serve as a marker of clinical vulnerability and identify patients who may benefit from closer clinical monitoring and medication review,” the authors wrote.

SOURCE

The study was led by Haowen Hsu of the Department of Pharmacy Practice in the School of Pharmacy and Pharmaceutical Sciences at the University at Buffalo in Buffalo, New York. It was published online on August 04, 2026, in the Journal of the American Geriatrics Society.

LIMITATIONS

The study’s cross-sectional design precluded the determination of cause and effect and did not eliminate the possibility of reverse causation.

DISCLOSURES

The study was funded by the Agency for Healthcare Research and Quality and the National Center for Advancing Translational Sciences. One author reported receiving support from the National Heart, Lung, and Blood Institute Loan Repayment Program. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.