PMID- 35664379
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 4
DP  - 2022 Apr
TI  - Fall-Risk-Increasing Drugs in People With Dementia Who Live in a Residential Aged 
      Care Facility: A Pilot Study.
PG  - e24559
LID - 10.7759/cureus.24559 [doi]
LID - e24559
AB  - Background  Psychotropic medications feature in prescribing guidelines for the 
      treatment of depression in dementia as well as the management of behavioural and 
      psychological symptoms of dementia (BPSD). They include antidepressants, 
      antipsychotics, and benzodiazepines, and are among an established collective of 
      pharmacotherapies known as fall-risk-increasing drugs (FRIDs). These psychoactive 
      medications are known to increase fall risk in elderly adults, including those 
      with a dementia diagnosis. Medication reviews are an integral part of falls 
      prevention programs in residential aged care and provide an opportunity to modify 
      medications to reduce fall risk related to pharmacotherapy. Objectives  This 
      pilot study explores the characteristics of a group of elderly people with 
      dementia living in residential care with a focus on patterns of falls and usage 
      of psychotropic medications. Methods  This is a retrospective study conducted 
      using data collected from health records. The Neuroscience-based Nomenclature 
      (NbN) classification of psychotropic medicines is employed to highlight relevant 
      pharmacological domains targeted by the medications rather than traditional drug 
      classes. Results  Four pharmacological neurotransmitter domains emerged as key 
      players in the pharmacotherapy of study participants. These were serotonin, 
      dopamine, noradrenaline, and gamma-aminobutyric acid A (GABA-A). Serotonin was 
      the most frequently implicated domain as related to observed usage of 
      psychotropic treatments for depression and BPSD. Over the retrospective study 
      period, 75% of participants were taking prescribed psychotropics known to target 
      these four domains, and most (69.4%) were elderly women over the age of 80. Many 
      participants experienced multiple falls, mostly among women, and most falls were 
      rated as harmful to some degree. Conclusion  This study observes recurrent falls 
      and frequent usage of psychoactive drugs in elderly people with dementia. We 
      conclude that further investigations are both warranted to support prescribing 
      guidelines for dementia and feasible according to the methodology of this pilot 
      study.
CI  - Copyright (c) 2022, Harris et al.
FAU - Harris, Caroline M
AU  - Harris CM
AD  - Medical School, Oceania University of Medicine, Corryong, AUS.
FAU - Lykina, Tatiana
AU  - Lykina T
AD  - Allergy and Immunology, Oceania University of Medicine, Saint Petersburg, RUS.
LA  - eng
PT  - Journal Article
DEP - 20220428
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9148191
OTO - NOTNLM
OT  - behavioural and psychological symptoms of dementia (bpsd)
OT  - depression in dementia
OT  - fall injury
OT  - psychoactive drugs
OT  - serotonin
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/06/07 06:00
MHDA- 2022/06/07 06:01
PMCR- 2022/04/28
CRDT- 2022/06/06 14:13
PHST- 2022/04/27 00:00 [accepted]
PHST- 2022/06/06 14:13 [entrez]
PHST- 2022/06/07 06:00 [pubmed]
PHST- 2022/06/07 06:01 [medline]
PHST- 2022/04/28 00:00 [pmc-release]
AID - 10.7759/cureus.24559 [doi]
PST - epublish
SO  - Cureus. 2022 Apr 28;14(4):e24559. doi: 10.7759/cureus.24559. eCollection 2022 
      Apr.