Pharmaceutical Treatment of People with Dementia during the SARS-CoV-2 Pandemic in Germany: Polypharmacy, Anticholinergic Medication, and Antidementia Medication.

Abstract

Introduction: Dementia patients are at increased risk of polypharmacy and inappropriate medication, exacerbating cognitive decline. The SARS-CoV-2 pandemic constrained access to medical care and monitoring services for dementia patients, potentially worsening medication-related issues. We analyzed the medical treatment of dementia patients during the SARS-CoV-2 pandemic in Bavaria, particularly regarding polypharmacy, anticholinergic medication, and antidementia medication.

Methods: The Bavarian Ambulatory COVID-19 Monitor (BaCoM) is a longitudinal registry study conducted in Bavaria, Germany. Participants in need of nursing care with baseline data during the SARS-CoV-2 pandemic were included in our detailed analysis (N = 345, dementia sample n = 96 with a dementia diagnosis and/or antidementia medication treatment). Descriptive statistics and group comparisons (dementia vs. non-dementia sample; within the dementia sample: participants with vs. without antidementia medication; participants with vs. without anticholinergic medication in both the non-dementia sample and the dementia sample) are provided.

Results: In the dementia sample, 91.7% of the patients received ≥4 medications (polypharmacy), 21.9% even ≥10 medications. Prescription of ≥1 anticholinergic medications was found in 65.6% and prescription of ≥1 antidementia medications in 31.2% of the dementia sample. Persons with versus without anticholinergic medication did not differ from each other in group comparisons.

Conclusion: Despite known risks and adverse effects, polypharmacy as well as the use of anticholinergic and antidementia medication were common among individuals with dementia. Compared to pre-pandemic studies, levels of polypharmacy and anticholinergic medication but not of antidementia medication appeared slightly elevated in people with dementia. Because of the associated risks, polypharmacy and potentially inappropriate medication require regular review (and when possible reduction) in people with dementia. In crisis situations like a pandemic, an outreach approach might be necessary for this patient group.