Queen's University Belfast

Academic Institute

Bernadette McGuinness

E051

Dementia is one of the greatest global challenges for health and social care in the 21st Century. Globally, about 47 million people are currently living with a dementia diagnosis. In Northern Ireland, it is estimated that 19,000 people are currently living with dementia. Dementia is a term used to describe a broad group of conditions that affect the brain and causes a progressive cognitive decline in the ability to think, learn and remember. At present there is no cure for dementia, nor a way to slow down its progress. The occurrence of dementia, together with the major health and social care burden associated with it, is predicted to increase considerably with our ageing population 1. Much research has drawn attention to the medication that people with dementia are being prescribed. For instance, research has shown that people with dementia (PwD) are likely to be taking more medications than people without dementia. More specifically, research has called into question the efficacy and dangers that different types of drugs may pose to PwD. Two classes of drugs which have been called into question are antipsychotics and antidepressants.2 Sustained use of antidepressants and antipsychotics among PwD has been shown to significantly increase the risk of death for PwD in comparison to people without dementia.3 There is a clear need to assess the rate of prescription of antipsychotics and antidepressants to PwD in Northern Ireland and whether this affects mortality rates.

It is estimated that 19,000 people have dementia in Northern Ireland 1. However, due to people living longer, the number of people being diagnosed with dementia will increase dramatically. With this in mind it is vital to assess the role that different drugs such as antipsychotics and antidepressants might play after a dementia diagnosis. Research from around the world has clearly indicated that people with dementia who are taking multiple comorbidity medications are likely to have increased mortality rates and more complex health requirements after their dementia diagnosis.4 Therefore, researchers and clinicians are attempting to devise methods which decreases the number of medications PwD are currently taking. One such method which has been proposed is a ‘drug holiday’ whereby a medication is withdrawn from a patient to assess the efficacy or remission symptoms of the medication.5 However, in order for these drug holidays to be effective, it is first necessary to understand which drugs the person is currently being prescribed and which ones are most associated with an increase in mortality rates. The research proposed in this application could form the basis of a practice which encourages clinicians to assess which antipsychotics and antidepressants a person with dementia is currently being prescribed and withdraw those which have been associated with adverse side effects and / or an increased likelihood of mortality.

04/10/2019

TRE