Deprescribing Acetylcholinesterase Inhibitors for Nursing Home Residents with Advanced Dementia

Little is known about benefits and risks of acetylcholinesterase inhibitors in patients with advanced dementia, but clinicians and families often are hesitant to discontinue these medications as dementia progresses. To evaluate the association between acetylcholinesterase inhibitor deprescribing and adverse events, researchers retrospectively analyzed Medicare claims and prescription data from 2016 for 37,000 U.S. nursing home residents with severe dementia. Rates of all-cause negative events (i.e., hospitalizations, emergency department visits, and mortality) and serious falls or fractures were compared in patients whose acetylcholinesterase inhibitors were discontinued and in those who continued taking these medications (most patients wer…