When to Stop Medications in Advanced Dementia

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I recently led a journal club where we reviewed, “Use of Medications of Questionable Benefit in Advanced Dementia.”1 This cross-sectional study examined medication use by nursing home residents with advanced dementia. Medications of questionable benefit were defined as “never appropriate” medications as determined by the consensus of a group of Geriatricians.2 

Over half of nursing home residents with advanced dementia (53.9%) received at least one medication of questionable benefit. The most commonly prescribed were cholinesterase inhibitors (36.4%) and memantine hydrochloride (25.2%). Continuing these medications does not increase survival or alter the course of advanced disease, can cause side effects, and contributes to increased health care costs.