Polypharmacy Observed in Over Half of Nursing Home Residents with Cognitive Disorders

A recent study observed polypharmacy in nursing home residents. While previous studies have confirmed the dangers of polypharmacy in the elderly, this study is unique because it specifically focuses on patients with cognitive disorders. Approximately 60% of nursing home residents suffer from some type of cognitive disorder. Patients with cognitive disorders, who are more likely to experience polypharmacy, are also at a heightened risk for suffering the dangerous side effects associated with polypharmacy. Patients with cognitive disorders such as dementia are often prescribed antipsychotic drugs. This leads to a complex type of polypharmacy because antipsychotic drugs can be particularly dangerous when mixed with other types of pharmaceuticals and lead to adverse drug reactions.

In this specific study, polypharmacy was considered in any residents taking five to nine drugs simultaneously. Patients taking over ten drugs at a time were categorized as experiencing excessive polypharmacy. All the patients included in the study suffered from advanced cognitive impairment. Of the 1,449 residents studied, 50.7% were observed with polypharmacy and 16.9% were observed with excessive polypharmacy. Patients in which polypharmacy or excessive polypharmacy were observed had a higher risk of developing heart disease, Parkinson’s, gastrointestinal disease, pain, and dyspnea.

The study makes it clear that polypharmacy should be avoided whenever possible. The use of pharmaceuticals must be minimized especially in patients who suffer from cognitive disorders. In dementia patients, use of antipsychotic drugs is known to trigger symptoms such as delirium and agitation. It important to note that these drugs are not intended to treat dementia. The Food and Drug Administration (FDA) does not approve of such use and warns of the dangers of using antipsychotics for off-label purposes. The Center for Medicare and Medicaid Services (CMS) has also recognized that antipsychotics are used rather excessively and unnecessarily in nursing homes and has initiated a program to reduce such use.
Understaffed nursing homes may use antipsychotic drugs for purposes of convenience to chemically restrain patients, who would otherwise require additional care and attention. While a non-pharmocological approach to treating dementia is always favorable, facilities that engage in neglect and elder abuse often sedate residents with antipsychotics before even attempting to use therapies that do not utilize pharmaceuticals. In addition to increasing the risks of polypharmacy unnecessarily, the use of antipsychotics as restraints violates your loved one’s Patients’ Rights. Non-profit organizations such as the California Advocates for Nursing Home Reform (CANHR) are working to end the abuse of antipsychotic drugs in skilled nursing facilities.


The attorneys at the Law Offices of Ben Yeroushalmi are dedicated to protecting the rights of victims of nursing home neglect. With years of experience in elder abuse litigation, we specialize in neglect cases and can help you with yours. If you believe your loved one is being chemically restrained, we encourage you to contact us today to speak with an elder abuse specialist.