Fall Risk and Psychotropic and General Medication Use in Dementia with Neuropsychiatric Symptoms
Bibliographic record
Abstract
BACKGROUND: Polypharmacy is common in older individuals with Alzheimer's disease and related dementia (ADRD) who present with neuropsychiatric symptoms (NPS). While it is associated with increased fall risk, specific impact of psychotropic and general medication use on fall risk in this population is not clear. We evaluated fall risk associated with psychotropic and general medication use in patients with ADRD and NPS while controlling for other clinical factors. METHOD: We used the following data from participants with a clinical diagnosis of AD and clinically significant NPS in the Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study (ClinicalTrials.gov/NCT03672201): number of psychotropic and general medications and scores on the Cohen Mansfield Agitation Inventory (CMAI) scores, Cumulative Illness Rating Scale-Geriatric (CIRSG), Functional Assessment Staging Tool (FAST). and Morse Fall Scale (MFS). Linear regression analyses evaluated the associations between psychotropic or general medication use and fall risk (MFS) while adjusting for age, CIRS-G, CMAI, and FAST scores. RESULT: 185 participants (female: 96 (52.5%)) were included, with mean (SD) age of 80.5 (9.8) years, mean FAST score of 9.1 (SD: 0.65; median stage: 6e). Psychotropic or general medications and CMAI or CIRS-G scores were not significantly associated with MFS, but FAST stage of dementia was. CONCLUSION: Fall risk in AD may be influenced more by functional and cognitive impairment than by medication use. These findings should be considered in the context of unique characteristics of this cohort that include a severe stage of dementia and the presence of significant NPS, and may inform fall risk management strategies in this population. References Gallagher, E., Mehmood, M., Lavan, A., Kenny, R. A., & Briggs, R. (2023). Psychotropic medication use and future unexplained and injurious falls and fracture amongst community-dwelling older people: Data from TILDA. European Geriatric Medicine, 14(4), 455-463. Zarei S, Choudhury S, Burhan AM, Chu L, Colman S, Derkach P, et al. Determinants of polypharmacy in patients with behavioral and psychological symptoms of dementia. Alzheimers Dement. 2021;17(S6).
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".