Medication Deviation in Dementia: A Scoping Review

Persons with dementia (PWD) often encounter challenges in effectively managing their medications, which can result in medication deviation. The objective of the current study is to provide references for enhancing the management of medication deviations among PWD.

A comprehensive literature search was conducted across six databases (PubMed, ProQuest, Web of Science, CNKI, Wanfang, VIP) to identify cross-sectional and cohort studies investigating medication deviations in PWD, published between January 1, 2015, and March 1, 2025. A scoping review methodology was used to summarize and analyze the basic characteristics, assessment tools, types of medication deviations, and influencing factors of included studies.

Twenty-one studies were included. Most used the Beers Criteria^® or STOPP criteria to assess medication deviations. Risk factors for deviations were categorized into three domains: individual factors (e.g., advanced age, cognitive impairment), caregiver-related factors (e.g., insufficient supervision), and medication-related factors (e.g., polypharmacy). Potentially inappropriate medications were the most prevalent type of deviation, with reported rates ranging from 12.2% to 85%.

Medication deviations are pervasive in dementia populations. Strengthening medication management protocols-including systematic medication reviews, caregiver education, and multidisciplinary interventions-is critical to reducing adverse drug events and preventable hospital readmissions. Future research should prioritize standardized assessment tools and context-specific strategies tailored to the neurobehavioral complexities of dementia.