Date of Award

12-2024

Document Type

Dissertation

First Advisor

Jason Brumitt

Abstract

Dementia is a progressive neurodegenerative condition characterized by cognitive decline and behavioral changes, which often necessitates polypharmacy to manage symptoms. There is a negative trade off to polypharmacy in that it increases the risks of falls and hospitalizations. Dementia patients are at an increased risk of falls and hospitalization, making it valuable to examine admission records to identify potentially modifiable risk factors. One of the most prevalent modifiable risk factors is polypharmacy in geriatric populations. Polypharmacy has become prevalent in older adults, not just in dementia. In 2013 a 3-year prospective cohort study of 1,742,336 people >65 years old looked at the number of prescriptions each person was given. They found that 44% of people were on 5-9 medications and 11.7% were on >10 medications. Medication lists are challenging for providers to effectively manage and optimize treatment plans. Providers must navigate many prescriptions while balancing a wide spectrum of behavioral changes and adverse effects. Behavioral changes attributed to progressive dementia include depression, anxiety, hallucinations, memory loss, and emotional instability. These neuropsychiatric changes are challenging to manage because psychotropic agents are not always effective, they have significant adverse effects, and many have drug to drug interactions.

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