A new study raises alarm about the increased use of antipsychotics and antidepressants among nursing home residents that began during the COVID-19 pandemic. The report also pointed to higher use of antipsychotics and gabapentinoids in dementia care facilities.
Researchers say the increases raise concerns about the risks for residents with cognitive impairments. The study was published Wednesday in BMC Geriatrics.
The team raised concerns that staffing levels and services in assisted living facilities were generally lower than in other settings, and that symptoms of dementia patients may have worsened during the pandemic. For this reason, the researchers examined the use of antipsychotics, antidepressants, antidementia drugs, benzodiazepines, and anticonvulsants in assisted living facilities and other dementia care settings, both before the pandemic and during certain waves of the pandemic.
The investigators evaluated data from all publicly funded assisted living facilities in Alberta, Canada, between January 2018 and December 2021. They focused on different waves of the pandemic: March to May 2020, September 2020 to February 2021, March to May 2021, and September to December 2021.
3.6% of the facilities surveyed offered dementia care only, 53.2% were assisted living facilities only, and 43.2% of the facilities had dementia care and assisted living services.
As of March 1, 2020, 2,779 residents were living in dementia care and 3,013 in other assisted living facilities. The average age of the residents was 83 years and 69% were female.
Antipsychotic use increased in both settings from the second to the fourth wave. It was more pronounced in dementia care during the third and fourth waves than in other assisted living settings.
There was a significant but modest increase in antidepressant use in both settings, while benzodiazepine use decreased during the study period. Among people with dementia, but not other assisted living residents, gabapentinoid use increased during several waves. The data showed a modest decrease in prevalent antidepressant use in both settings in the second wave, but otherwise remained relatively stable.
The study authors expressed concern about the continued increase in the use of these drugs, which affect the central nervous system, as they may increase the risk of motor dysfunction, syncope (fainting spells) and falls in people with cognitive impairment. They called for further research into the factors that favor the use of such drugs, as well as the potential health consequences for nursing home residents with dementia.
