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Nursing home residents with advanced dementia, a terminal illness with severe cognitive and functional impairment, often receive numerous medications, some of which are inappropriate and can engender unnecessary expenses and side effects.
In this cross-sectional study, researchers used a large U.S. national pharmacy database (linked with Medicare data) to identify more than 5400 people (median age, 85) with advanced dementia (mean Mini-Mental State Examination score, 5) who were residing in long-term care facilities. Nearly 70% had do-not-resuscitate orders. Fifty-four percent were taking at least one medication of questionable benefit — most commonly, cholinesterase inhibitors, memantine, lipid-lowering agents, or antiplatelet agents. Among…