Report: Nearly half of older adults living alone with cognitive impairment take a high-risk drug

A new study comparing older adults with cognitive impairment who lived alone to those who lived with others found that those living alone used a median and five prescription drugs, and at least one high-risk medication.

On the flip side, those living with others were on a median of six medications. Those people took slightly more high-risk medications compared to those living alone. High-risk drugs included sedating medications, opioids, anticoagulants, sulfonylurea, and insulin.  

The report was published on July 26 in the Journal of the American Geriatrics Society.

Researchers used data from the National Health and Aging Trends Study as well as Medicare claims from 2015 to 2017. In total, they evaluated 1,569 older adults with cognitive impairment; of them, 491 lived alone. The average age of people was nearly 80 years old and 66% were women. The team looked at the frequency as well as types of high-risk medications, and compared it to those living with others over a three-year period.

More than 25% of older adults in America who have cognitive impairment live alone. These individuals often are lacking on medication management support, and are at a higher risk for adverse drug events, the authors wrote.

Among participants living alone, 64% said they were managing their medications without difficulty, 14% reported difficulty and 18% had complete support with medication management. In total, 16% took 10 or more medications and 46% took one or more high-risk medications. 

Compared with those who lived with others, the use of high-risk medications was similar. People living solo were more likely to take at least one high-risk medication and not receive help with medication management.

Of those living alone, 79% didn’t get help with medication management, and 18% received total support. Among those living with others, 54% didn’t get help managing their medications while 42% had total support. About 14% living solo had some difficulty managing their medications, and 9% residing with others showed the same. 

The most commonly used high-risk medications were highly sedating and/or anticholinergic medications. “This is a particularly concerning finding given the well-documented risks of these medications — especially in older adults with cognitive impairment who face the challenge of managing complex medication regimens without ready access to tangible help from others,” the authors wrote.