Persons diagnosed with dementia are often faced with challenges related to polypharmacy and inappropriate medication use and could benefit from regular medication reviews. However, the benefit of such reviews has not been examined in this population. Therefore, the current scoping review was designed to identify the gaps in the current knowledge regarding the impact of medication reviews on the clinical outcomes in older adults with dementia. Relevant studies were identified by searching three databases (Ovid MEDLINE, Ovid EMBASE, and Scopus) from inception to January 2022 with a combination of keywords and medical subject headings. After the removal of duplicates and ineligible articles, 22 publications of the initial 8346 were included in this review. A total of 57 outcomes were identified, including those pertaining to the evaluation of medication use (n = 17), drug-related interventions (n = 11), drug-related problems (n = 10), dementia-related behavioral symptoms (n = 8), cost-effectiveness (n = 2), drug-related hospital admissions (n = 1), as well as outcomes classified as other (n = 7). Gaps identified through this scoping review included the paucity of studies measuring the impact of medication reviews on the medication management capacity and medication adherence, quality of life, and mortality.

Background: Since the past decade, prevalence of Potentially Inappropriate Medication (PIM) among elderly inpatients has increased drastically. However, limited data is available on PIM indicators and PIMs use among the elderly in patients suffering from Chronic Kidney Disease (CKD). Objective: The objective of this study is to determine the prevalence of PIMs in elderly hospitalized patients with CKD. Methods: A cross-sectional study was carried out on 102 patients in a tertiary care hospital. PIMs were identified using Beers criteria 2019. Chi-square test was used to identify the association between variables and PIMs use. Results: PIMs, as assessed according to AGS updated Beers criteria 2019 was found to be in more than 68.6% of patients of median age 65 years and 3 diagnoses and 7 days median length of stay. Most of the patients (47.1%) had ≥4 diagnosis. The most common comorbidities in patient were diabetes mellitus (n=54) and hypertension (n=55). Most of the subjects (66.7%) were on polypharmacy (5-9 medications/day) and 25.5% were on a higher level of polypharmacy (>10 medicines/day). Approximately 90% of the patients were having very low CrCl < 21ml/min (calculated with the help of Cockcroft- Gault formula). A significant association between PIM use and an increased number of diagnoses, polypharmacy or high-level polypharmacy, was observed. Conclusion: The prevalence of PIMs in elderly inpatients suffering from CKD is quite high. The study clearly indicates negligence/ lack of awareness amongst physicians leading to increase in PIM use. Authors propose that the CKD patients should attract special attention of physician and should be treated as brand ambassadors/alarming bell for PIM use.

Frailty among older adults heightens their risk of negative health outcomes, and medication use plays a major role in this increased vulnerability. Various aspects of medication use elevate the risk of poor outcomes in individuals with frailty. The current scoping review was designed to explore medication use in older adults with frailty in primary care, focusing on the prevalence of potentially inappropriate medications (PIMs), polypharmacy, medication adherence, and their role in contributing to adverse drug events. This scoping review was conducted using the Arksey and O’Malley, supplemented by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews (PRISMA-ScR) guidelines. A search of the literature was conducted from inception to November 2023 in Ovid EMBASE, PubMed (MEDLINE), Scopus, EBSCOhost CINAHL, and Ovid International Pharmaceutical Abstracts. Studies which met the eligibility criteria included older adults with frailty (≥65 years) living at home, defined frailty criteria, and assessment of medication use. Out of the 4726 studies screened, 223 were included, conducted across 39 countries. Frailty prevalence varied widely from 0.9% to 89.2%. Polypharmacy (5–9 medications) and hyper-polypharmacy (≥10 medications) were notably more common among individuals with frailty, with polypharmacy rates ranging from 1.3% to 96.4%. Twelve studies reported PIM prevalence among individuals with varying levels of frailty, ranging from 2.4% to 95.9%. This scoping review highlights the challenges and complexities involved in understanding the relationship between medication use and frailty in older adults.

Potentially inappropriate medications (PIMs) increase the risk of adverse drug reactions, hospitalizations, and worsened health outcomes in older adults, particularly those with cognitive impairment (CI) or dementia. This study was designed to compare the Beers Criteria^® 2023 and the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) Criteria 2023 to determine which identifies a higher prevalence of PIMs in older adults with CI or dementia attending primary care-based memory clinics. PIMs were identified with the use of the updated Beers Criteria^® 2023 and STOPP Criteria 2023, from electronic medical records of study participants from January to August 2023. The study identified PIMs and analyzed associated risk factors using bivariate logistic regression. Of 44 older adults, 47.7% (n = 21) were detected with one PIM based on Beers Criteria^® 2023, and 27.2% (n = 12) were identified with at least one PIM using STOPP criteria. Using the updated Beers Criteria^® 2023 and STOPP Criteria 2023, the study identified 50 PIMs (averaging 0.9 PIMs per participant) based on Beers Criteria^® and 31 PIMs (averaging 0.6 PIMs per participant) based on STOPP Criteria, respectively. Bivariate logistic regression revealed a significant association between having nine or more comorbidities and PIMs according to Beers Criteria^® (odds ratio (OR) = 8.4, 95% confidence interval (CIn) = 1.27–55.39, p = 0.027). This study highlights the high prevalence of PIMs among older adults with CI or dementia, emphasizing the need for regular medication reviews. Implementing both criteria can enhance medication management and improve patient safety in this vulnerable population.

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.

Background: Medication adherence technologies (MATs) offer innovative solutions to support older adults in managing complex medication regimens, yet usability challenges can prevent their successful use. Older adults often face cognitive, physical, sensory, motivational, and environmental barriers, which can influence how they interact with these devices. Therefore, performance-based usability testing is essential for identifying usability issues. Objective: This study aimed to evaluate the performance-based usability and user experience of 13 MATs among older adults with diverse capabilities. Methods: A prospective mixed methods design was used, with 96 participants aged 60 years and older testing smart and electronic MATs using cognitive walkthroughs and predefined usability tasks without formal training to simulate first-use conditions. This manuscript focuses specifically on the performance-based usability metrics collected as part of the mixed methods study. Validated tools, including the Self-Medication Assessment Tool (SMAT), Daily Living Tasks Dependent on Vision (DLTV), Whisper Test, Self-Efficacy for Appropriate Medication Use Scale (SEAMS), and Martin and Park Environmental Demands (MPED) Questionnaire, were used to assess individual barriers. Poisson generalized estimating equations (GEE) was used to determine predictors of unassisted task success and error rates while accounting for repeated observations. Results: A total of 96 participants (mean age 75.1, SD 7.7, range 61‐95 y) were included, with 37.5% (36/96) male and 62.5% (60/96) female. Poisson GEE models identified significant predictors of unassisted task success rate, including cognitive score ( P <.001), physical score ( P <.001), vision score ( P <.001), motivational score ( P <.001), and lower environmental busyness ( P =.049). Female sex was associated with a 9% lower success rate ( P =.002). Predictors of total error rate included age ( P =.02), sex ( P ≤.001), physical score ( P ≤.001), vision score ( P =.004), DLTV vision score ( P =.01), MPED routine score (environmental; P =.05), and interaction between physical score and sex ( P =.004). Conclusions: Both device design and user characteristics strongly influence the usability of MATs. Performance-based evaluations provide actionable findings for user-centered design and selection, guiding manufacturers and health care providers toward developing and choosing accessible technologies that could improve medication adherence among older adults.