Many older adults who suffer from cognitive disability also display challenging or problem behaviors. These types of behaviors threaten the physical safety of the individuals or others or cause community facilities to become inaccessible. There has been much concern for many years regarding the use of psychotropic drugs—specifically, antipsychotics—that are used inappropriately in patients with cognitive disability and that are often prescribed solely for challenging behavior rather than for diagnosed cognitive illness, despite lack of substantial evidence.
A recent study aimed to describe the incidence of recorded cognitive illness and problem behavior in older adults with cognitive disability in primary care and analyzed the prescription of psychotropic drugs in this group. The study found that the proportion of older adults with cognitive disability who had been treated with psychotropic drugs far exceeded the proportion with recorded cognitive illness. These drugs are often prescribed to patients without recorded severe cognitive illness but who have a record of problem or challenging behavior. These findings suggest that the efficacy and safety of psychotropic drugs in this group should be reevaluated, particularly when they are used for treating challenging behavior.