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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on October 20, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/glp158
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Potentially Inappropriate Medication Use in Older Adults With Mild Cognitive Impairment

Andrea L. Weston1,2, Andrea M. Weinstein1,3, Cynthia Barton1,4 and Kristine Yaffe1,2,4,5

1 Department of Geriatric Psychiatry, San Francisco Veterans Affairs Medical Center, California
2 Department of Psychiatry, University of California, San Francisco
3 Northern California Institute for Research and Education, San Francisco
4 Department of Neurology
5 Department of Epidemiology and Biostatistics, University of California, San Francisco

Address correspondence to Andrea L. Weston, MPH, Department of Psychiatry, University of California, San Francisco, Box 116H, 4150 Clement Street, San Francisco, CA 94121. Email: andrea.weston{at}ucsf.edu


  Abstract

Background: Patients with mild cognitive impairment (MCI) may be especially vulnerable to the side effects of potentially inappropriate medications (PIMs), especially those that impair cognition.

Methods: We conducted a cross-sectional study to determine the prevalence of PIM use among 689 patients with MCI. We used the 2003 Beers Criteria for cognitive impairment to identify PIMs. We then determined if certain patients were more likely to use PIMs.

Results: There were 143 (20.8%) patients with MCI taking a PIM: 108 (15.7%) patients were taking one PIM and 35 (5.1%) patients were taking two or more PIMs. The most common PIMs were anticholinergics (35.7%) and benzodiazepines (31.5%). Patients were more likely to be taking PIMs if they were women and were taking a greater number of medications and less likely if they had a history of myocardial infarction.

Conclusions: Patients with MCI are frequently taking PIMs that may negatively affect cognition. Future research is needed to assess whether cognitive impairment symptoms are improved if PIM use is reduced.

Keywords Mild cognitive impairment; Potentially inappropriate medication; Epidemiology

Received: April 24, 2009; Accepted: September 22, 2009

Decision Editor: Luigi Ferrucci, MD, PhD


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