ABSTRACT Aim Few studies have examined the occurrence of adverse drug reactions (ADRs) in relation to the severity of cognitive impairment in patients with dementia. This study aimed to investigate the prevalence of ADRs among older adults living with dementia at the time of admission according to the severity of cognitive impairment. Methods This retrospective chart review included patients living with dementia between July 2021 and December 2022. Severity of cognitive impairment was classified using the Mini‐Mental State Examination scores as mild (≥ 21), moderate (11–20), and severe (≤ 10). ADRs were evaluated based on national guidelines for appropriate medication use in older adults or pharmacologically plausible associations. ADR‐related hospitalization was defined as ADRs that were considered to have directly or indirectly contributed to the decision to admit the patient. The collected data and the relationship between medication counts and ADR‐related hospitalization (6–9 versus ≥ 10 medications) were analyzed according to the severity of cognitive impairment. Results This study included 35, 100, and 78 patients in the mild, moderate, and severe groups, respectively. At discharge, the severe group was prescribed significantly fewer medications than the mild group ( p < 0.05). The prevalence of ADRs decreased in each group from admission to discharge (mild: 77.1%–17.1%; moderate: 74.0%–16.0%; severe, 82.1%–33.3%). Among patients taking 6–9 medications, ADR‐related hospitalization was more common in the severe (50.0%) group than the mild group (20.0%) ( p < 0.016) at the time of admission. Conclusion Patients living with dementia who have severe cognitive impairment are particularly vulnerable to adverse drug reactions.
Tempaku et al. (Sun,) studied this question.