Poisoning Exposures in People with Dementia (2014‒2019): A Retrospective Study

To describe the most common types of poisoning exposures, implicated substances and underlying sources of medication error in people with dementia.

Retrospective analysis of call records from the New South Wales (NSW) Poisons Information Center (PIC).

People with dementia who had a poisoning exposure reported to the NSW PIC (Australia's largest PIC).

A retrospective study was conducted using data from the NSW PIC from July 2014 to July 2019. All calls pertaining to individuals with a reported diagnosis of dementia (Alzheimer's disease or other) or who were taking an antidementia drug were included. Descriptive analysis was performed to characterize poisoning exposures, substances involved, and sources of error.

A total of 2726 cases involving individuals with dementia [mean age = 79.5 (standard deviation 11.0) years; 56.2% female] were reported to the NSW PIC after intentional or unintentional poisoning. Therapeutic errors comprised 1692 (62.1%) of all reported cases followed by accidental exposures which contributed 711 (26.1%). The most common therapeutic substances responsible for therapeutic errors were donepezil (137 cases, 8.1%) and paracetamol (87 cases, 5.1%). The greatest proportion of all accidental exposures was attributed to hand sanitizer (46 cases, 6.5%). Over one-half of therapeutic errors (n = 1021, 60.3%) were linked to double dosing or mistiming of medications, and nursing home or carer errors were implicated in 385 cases (22.8%). Calls were most commonly made by family (n = 1187, 43.5%) and handled at home (n =1444, 53.0%).

Therapeutic errors and accidental poisonings are of concern in people with dementia. Strategies to reduce these potentially preventable adverse events should be further explored.