Key result
Heart failure medications are discontinued in ~95% of patients with dementia entering hospice.
Why the study?
Heart failure and Alzheimer's disease and related dementias frequently co-occur, complicating medication management at the end of life.
Observational (n=1,128)
Heart failure medications are almost universally discontinued at hospice admission among patients with concomitant HF and dementia, regardless of which condition is the primary diagnosis.
Answers are grounded in this paper and cite their sources.
High discontinuation rates of heart failure medications at hospice admission in dementia patients warrant review of deprescribing practices; leaves open effects on symptoms and survival.
BACKGROUND: Heart failure (HF) and Alzheimer's disease and related dementias (AD/ADRD) frequently co-occur, complicating medication management at the end of life. METHODS: = 1128). HF-related medication use and discontinuation at hospice admission were characterized and compared by diagnosis primacy. RESULTS: Prehospice use was highest for beta-blockers (44.0%), loop diuretics (32.4%), and renin-angiotensin-aldosterone system (RAAS) inhibitors (17.7%). Among patients with documented use, discontinuation was 91.2%-100% across medication classes, including beta-blockers (97.5%), loop diuretics (97.0%), and RAAS inhibitors (94.1%). Discontinuation did not differ by HF diagnostic primacy. CONCLUSIONS: HF-related medication discontinuation was common at hospice admission among patients with HF and AD/ADRD, regardless of HF diagnostic primacy. Further research is needed to understand the clinical rationale and symptom outcomes associated with medication discontinuation in hospice.
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Moreines et al. (2026) conducted an observational in Concomitant Heart Failure and Dementia (n=1,128). Heart failure diagnostic primacy vs. Secondary heart failure diagnosis was evaluated on Heart failure-related medication discontinuation at hospice admission. Heart failure medication discontinuation was highly prevalent (91.2%-100%) at hospice admission among patients with heart failure and dementia, regardless of heart failure diagnostic primacy.
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