Racial Differences in Antidepressant Use in Nursing Facility Residents With Moderate to Severe Cognitive Impairment

Area of Science:

• Gerontology
• Psychiatry
• Health Disparities

Background:

• Nursing facility residents with cognitive impairment often experience behavioral and psychological symptoms.
• Antidepressant use is common in this population, but prescribing patterns may vary by race.

Purpose of the Study:

• To compare antidepressant use between Black or African descent and White nursing facility residents with moderate to severe cognitive impairment.
• To identify potential racial disparities in psychotropic medication prescribing.

Main Methods:

• Secondary data analysis of a randomized control trial involving 336 nursing facility residents.
• Participants were aged 55+, English-speaking, with Mini Mental-State Examination scores ≤15.
• Data collected via observation, staff proxy report, and patient charts.

Main Results:

• Black or African descent residents were significantly less likely to be prescribed antidepressants compared to White residents.
• This disparity persisted after controlling for depression, age, gender, functional status, agitation, and comorbidities.

Conclusions:

• Racial differences in antidepressant prescribing were observed in nursing facility residents with cognitive impairment.
• Further research is required to determine if race impacts prescribing when indications for use are known, potentially contributing to disparities.