A new study is sounding the alarm on increased use of antipsychotic and antidepressant medications in assisted living residents that began during the COVID-19 pandemic. The report also called out higher use of the antipsychotic and gabapentinoid drugs in dementia care settings.
Researchers say the increases are raising concerns about the risks for residents with cognitive impairment. The study was published Wednesday in BMC Geriatrics.
The team expressed concerns that staffing levels and services are typically lower in assisted living centers than other settings, and that residents with dementia may have had worsening symptoms during the pandemic. That’s why the researchers evaluated the use of antipsychotic, antidepressant, anti-dementia, benzodiazepine, and anticonvulsant drugs in assisted living centers and other dementia care settings, both before the pandemic and during specific waves of the pandemic.
Investigators assessed data from all publicly funded assisted living facilities in Alberta, Canada, between January 2018 and December 2021. They focused on different waves of the pandemic: March to May 2020, September 2020 to February 2021, March to May 2021, and September to December 2021.
Of the settings studied, 3.6% of homes only offered dementia care, 53.2% were only assisted living facilities, and 43.2% of settings had dementia care and assisted living services.
As of March 1, 2020, there were 2,779 dementia care and 3,013 other assisted living residents in the facilities. The average age of residents was 83 and 69% were female.
Antipsychotic use increased from the second through the fourth waves in both settings. It was more pronounced in dementia care than other assisted living settings during the third and fourth waves.
In both settings, a significant but modest increase in antidepressant use occurred while benzodiazepine use went down during the study period. Among dementia care residents, but not among other assisted living residents, gabapentinoid use went up during several waves. Data showed a modest decrease in prevalent anti-dementia drug use for both settings in the second wave but otherwise remained relatively stable.
The study authors expressed concern about the sustained increases in the use of these drugs that affect the central nervous system, as they can increase the risk for impaired motor function, syncope (fainting) and falls among people with cognitive impairment. They called for further research on the factors driving the use of such medications, as well as the potential health consequences for assisted living residents with dementia.
