# Unnecessary and Harmful Medication Use in Older Adults with Dementia

> **NIH NIH P01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2022 · $179,196

## Abstract

RP3 PROJECT SUMMARY
People with dementia (PWD) who live in the community often have multiple comorbid medical conditions,
resulting in extensive medication use. While medications can yield many benefits, they can also result in
substantial harms. Medications commonly prescribed to older adults can impair cognition, increase fall risk,
and cause other serious outcomes, often serve no discernible purpose, and are frequently inconsistent with
remaining life expectancy and goals of care. Such problems may be particularly common and damaging for
PWD given this population’s enhanced susceptibility to adverse drug effects, difficulty communicating drug-
related symptoms, and often limited life expectancy. Reducing use of medications that are unnecessary or
likely to cause more harm than good can thus play a critical role in improving quality of life for PWD. Yet,
efforts to achieve this are compromised by fundamental gaps in knowledge. While prior studies have
documented frequent use of selected inappropriate medications in community-dwelling PWD, much less is
known about use of other types of unnecessary and harmful medications such as unnecessarily aggressive
disease management, duplicative therapies, medications with no clear indication, and medications
inappropriate near the end of life, and little is known about which risk factors may drive use of problematic
therapies. In addition, efforts to reduce use of problematic medications in PWD are likely to be more successful
if they align with patient and caregiver attitudes and preferences toward medication use, yet much remains
unknown about this topic. We seek to resolve these knowledge gaps through a series of linked specific aims
that take advantage of high-value national data sources, including the Health and Retirement Study (HRS),
National Health and Aging Trends Study (NHATS), and Medicare Parts A, B, and D. Using linked HRS and
Medicare data, we will evaluate a broad range of unnecessary and harmful medication use in community-
dwelling PWD, and assess which risk factors and clinical circumstances may lead to especially high use of
unnecessary and harmful medications. In addition, we will capitalize on unique data elements present in
NHATS to explore the attitudes of PWD and their caregivers toward medications and opportunities to reduce
medication use. Our aims are (1) To characterize the frequency and types of unnecessary and harmful
medication use in community-dwelling PWD, and to compare this to usage patterns in people without
dementia; (2) To evaluate risk factors for use of unnecessary and harmful medication use among community-
dwelling PWD, with a special focus on the role of hospitalization, and to determine whether these risk factors
are different than in people without dementia; and (3) Using validated survey questions from NHATS, to
characterize the attitudes of community-dwelling PWD and their caregivers toward their medications and their
willingness to stop medications. Informat...

## Key facts

- **NIH application ID:** 10465161
- **Project number:** 5P01AG066605-03
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Kenneth S. Boockvar
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $179,196
- **Award type:** 5
- **Project period:** 2020-09-30 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10465161

## Citation

> US National Institutes of Health, RePORTER application 10465161, Unnecessary and Harmful Medication Use in Older Adults with Dementia (5P01AG066605-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10465161. Licensed CC0.

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