Potentially inappropriate medication use among older adults with cognitive impairment and dementia attending primary care‐based memory clinics
Bibliographic record
Abstract
Abstract Background The use of potentially inappropriate medications (PIMs) in older adults with dementia and/or Mild Cognitive Impairment (MCI) has been associated with increased adverse events, drug‐related problems (DRPs), prolonged hospitalization, risk of falls, and increased length of stay. This study aimed to identify which explicit tool, Beers criteria 2023 or Screening Tool of Older Persons Potentially Inappropriate Prescriptions (STOPP) 2023, identifies more PIM use among older adults with MCI or dementia. Methods A cross‐sectional study was conducted at a Multispecialty Interprofessional Team‐based (MINT) memory clinic. Patients with MCI or dementia were recruited between Jan and August 2023. Patient medical records were reviewed for PIMs using Beers Criteria 2023 and STOPP criteria 2023. Bivariate logistic regression analysis was employed to identify potential factors associated with the use of PIMs. Results Overall, 44 participants were enrolled in the study, with a mean age of 80.2± 6.2 years. Among 44 patients, 36.4% (n = 16) patients had MCI, followed by one‐fifth of patients (n = 9) who had mixed dementia and 11.4% (n = 5) with vascular cognitive impairment. At least one PIM was identified in 47.7% (n = 21) and 27.2% (n = 12) of the study participants based on Beers' and STOPP’s criteria, respectively. Using the Beers criteria, 50 PIMs were found, with an average of 0.9 PIMs for each patient, while a total of 31 PIMs were identified using the STOPP criteria, with an average of 0.6 PIMs per patient. There was a significant association between ≥ 9 number of comorbidities and PIMs as per Beers criteria (OR = 8.4, 95% Confidence interval: 1.27‐ 55.39, P = 0.027). However, no statistically significant association was observed with PIMs as per STOPP criteria. Conclusion The frequency of PIMs identified using Beers and STOPP criteria highlights the importance of identifying and addressing PIMs in this population. This study adds valuable insights to the progressing comprehension of medication‐related complexities in older adults living with MCI or dementia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".