[Use of antidementia drugs at the end of life]

The use of antidementia drugs near the end of life remains controversial. We evaluated the prevalence of and factors associated with antidementia drug use in the last 6 months of life in older adults with dementia.

Observational retrospective study of adults ≥60 years, affiliated to the Hospital Italiano de Buenos Aires health maintenance organization, who died with a dementia diagnosis, between 2017 and 2021. The main event was the use of antidementia drugs in the 6 months prior to death. We fit a logistic regression model to estimate odds ratios (OR) and 95% confidence intervals (CI) of baseline variables associated with antidementia drug use.

A total of 540/1898 (28%) patients used antidementia drugs in the 6 months preceding death. Lewy body dementia (OR=1.97; 95%CI, 1.22-3.19) and Alzheimer's disease (OR=1.47; 95%CI, 1.12-1.92) were associated with higher odds of antidementia drug use. Heart failure (OR=0.65; 95%CI, 0.48-0.89), older age (OR=0.75; 95%CI, 0.68-0.81), and prior hospitalizations (OR=0.81; 95%CI, 0.70-0.93) were inversely associated with antidementia drug use.

One out of three patients with dementia receive antidementia drugs in the 6 months prior to death despite limited evidence in such a scenario.