Three or more brain-active drugs: three in ten nursing home residents with dementia

The edition in brief

Among 485,251 long-stay US nursing home residents, 70% with dementia, potential drug–drug interactions were slightly more common in those with dementia (58.0% vs 53.3%, prevalence ratio 1.09) and lasted longer for 34 of 98 interactions; 29.6% of residents with dementia were exposed to three or more central nervous system-active drugs, against 21.2% without. In 1,299 older inpatients in Japan, a higher Charlson Comorbidity Index was associated with hospital-associated disability in people who were not frail (OR 1.44 per point) but not in those who were frail, so comorbidity counts lost their predictive value as frailty increased. In 114,055 Ontario adults over 66 admitted with hip fracture, benzodiazepine dispensing after discharge fell from 34% to 13% between 2008 and 2024, while opioid dispensing remained near 45%. A meta-analysis of 37 observational studies found dementia associated with 62% higher odds of suicidal behaviour, with risk concentrated in younger patients, men, the socially isolated and those with depression.