People with dementia prescribed risky drugs
February 10, 2026
People with dementia prescribed risky drugs
At a Glance
- Researchers found that many older adults with dementia were prescribed medications that can increase the risk of confusion, falls, and hospitalization.
- Reducing such unnecessary prescriptions could improve the quality of care for older adults.
Prescription drugs that affect the brain and nervous system may increase the likelihood of confusion, falls, and hospitalizations. This is a particular concern for older adults with impaired thinking or judgment. Clinical guidelines identify which medications older adults should avoid and when. But these medications continue to be prescribed.
An NIH-funded research team led by Dr. John N. Mafi of UCLA aimed to understand who is being prescribed these medications and why. To do so, they analyzed data from a nationwide survey linked to Medicare insurance claims submitted from 2013 to 2021. They focused on people ages 65 and older who had at least two years of continuous Medicare insurance coverage. About 4,800 of the survey participants fit these criteria. Results of the study appeared in JAMA on January 12, 2026.
The team measured the proportion of people prescribed at least one or more “potentially inappropriate medications” affecting the brain and nervous system for at least 28 days. These drugs included certain antidepressants, antipsychotics, barbiturates, benzodiazepines, and nonbenzodiazepine hypnotics. The antidepressants selected have been linked to cognitive impairment in older adults. The last three drug classes tamp down the nervous system and can be habit-forming.
Prescribing patterns emerged from the data. The percentage of people prescribed potentially risky drugs decreased from about 20% to 16% between 2013 and 2021. But more than two-thirds of people receiving these prescriptions lacked a documented clinical reason for them.
People with cognitive impairment were more likely to receive potentially inappropriate prescriptions. Twenty-five percent of patients with dementia were prescribed at least one of these medications. In contrast, only 17% of people with normal cognition were.
Benzodiazepines and nonbenzodiazepine hypnotics were the most prescribed risky medications. However, their use declined during the study period. Prescription rates for the other drug classes were lower and changed little.
The results suggest that many older adults still receive risky medications. Reducing the use of these medications could improve quality and safety of care.
“While prescriptions affecting the central nervous system may be appropriate in some cases, it is important for older patients or their caregivers to work closely with their physicians to ensure that these medications are appropriate to their cases,” says lead author Dr. Annie Yang. “When inappropriate, patients and their care teams should consider alternative treatments and consider whether it might be safe to taper or stop the medication.”
—by Caroline Stetler
Related Links
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- Antioxidant effects on dementia risk may differ
- Lack of sleep in middle age may increase dementia risk
- Dealing with dementia
- What is dementia? Symptoms, types, and diagnosis
- Alzheimer's disease & related dementias
References
Prescribing Patterns of Potentially Inappropriate CNS-Active Medications in Older Adults. Yang AW, Leng M, Ly DP, Tseng CH, Sarkisian C, Damberg CL, Harawa NT, Fendrick AM, Mafi JN. JAMA. 2026 Jan 12:e2523697. doi: 10.1001/jama.2025.23697. Online ahead of print. PMID: 41525063.
Funding
NIH’s National Institute on Aging (NIA).
