Psychotropic Polypharmacy Among Belgian Nursing Home Residents With Mild to Moderate Dementia

Dementia is the most common reason for nursing home admission and is increasingly prevalent. Behavioral and psychiatric symptoms are common in dementia and are commonly treated with psychotropic medications. However, nursing home residents are especially vulnerable to the adverse effects of potentially inappropriate medication. This observational study aimed to determine the rate of psychotropic drug use and psychotropic polypharmacy among Belgian nursing home residents with mild to moderate dementia.

This is a cross-sectional study examining the prevalence of psychotropic medication use.

Data were collected from the charts of 494 residents with dementia in 23 Belgian nursing homes.

Medications were categorized according to the Belgian Centre for Pharmacotherapeutic Information. The total number of psychotropic medications and prevalence of psychotropic polypharmacy (≥2 daily psychotropic medications) were calculated, and the effects of age, sex, duration of nursing home stay, dementia severity, and severity of neuropsychiatric symptoms were examined.

A total of 68.6% of residents used at least 1 kind of psychotropic medication, 40.3% used ≥2, and 14% used ≥3. Hypnotics, sedatives, and anxiolytics were the most prescribed category (45.3%), followed by antidepressants (33.0%) and antipsychotics (29.6%). Younger age and female sex were associated with a higher number of psychotropic medications used. More severe polypharmacy was also associated with higher severity of neuropsychiatric symptoms.

There is a high prevalence of psychotropic drug use among Belgian nursing home residents with dementia. This is comparable with findings in other countries. Considering the risk of adverse effects, we advise further efforts to review the use of potentially inappropriate medications.