June 21, 2019

Hart’s research shows risk in older adults with dementia taking CNS-active medications

While competing  the postdoctoral fellowship in geriatric pharmacy here at the UWSOP, alumna Laura Hart, PharmD, MS, BCPS, BCGP,’14, ’17, was awarded a research grant by the American College of Clinical Pharmacy (ACCP) Research Institute Futures Grants program. Her research focused on the impact central nervous system (CNS)-active medications have on older adults with dementia. She was particularly interested to see how these medications affect the risk of falls in this population. From that research, she published, “The Association Between Central Nervous System-Active Medication Use and Fall-Related Injury in Community-Dwelling Older Adults with Dementia,” in the journal, Pharmacotherapy.

She and her research team, which includes Plein Center Director Shelly Gray and Plein Center Assistant Director Zach Marcum, found that current use of CNS-active medications was associated with an increased risk of fall-related injury, which includes fracture, dislocation, or head injury, even at low doses.

“Our results reinforce the importance of cautious use and close monitoring of CNS-active medications in older adults with dementia. It is important for clinicians to address medication use as part of a comprehensive effort to prevent falls, carefully weighing the risks versus benefits of a given medication.”—Laura Hart, PharmD, MS’14, ’17,

CNS-active medications include antidepressants, anticholinergics, antipsychotics, benzodiazepines, sedatives/hypnotics, and opioids, and are widely used in populations of older adults, including those with dementia.

The study used data from the Adult Changes in Thought (ACT) study, which has been following a population of Kaiser Permanente Washington patients since 1986. The database is widely regarded as providing a rich source of information for researchers to understand better the impact medications can have on older adults.

Laura sees future research opportunities in measuring the effects of CNS-active medications over time for older adult patients with dementia, as well as evaluating which specific medication classes pose greatest risk.

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