A landmark national study has found that aged care residents with dementia are being prescribed high-risk antipsychotic medications at twice the rate of other residents, despite an overall decline in their use following recent government reforms.
The Macquarie University research, the first of its kind since the Aged Care Royal Commission, revealed a “concerning” disparity in medication practices. While antipsychotic use has dropped, it remains at 23% for residents with dementia compared to just 11% for those without.
Lead researcher Associate Professor Magda Raban from the Australian Institute of Health Innovation said these drugs carry “significant risks, including increased risk of stroke and death” and should only be used as a last resort.
“This is concerning because it suggests that people with dementia are still being disproportionately exposed to medications that carry serious risks,” Raban said.
The study, which analysed data from nearly 38,000 residents between 2018 and 2022, also uncovered a rising trend in antidepressant use among those with dementia, increasing from 42% to 48%—meaning almost half are now taking them.
Raban suggests this may indicate a shift away from antipsychotics to antidepressants, which are “possibly perceived as a safer alternative.”
“However, antidepressants also have side effects and limited evidence of benefit for behavioral symptoms, including depression, in dementia. So this warrants careful monitoring, to make sure antidepressants don’t replace antipsychotics, and that the positive trends continue.,” she said.
The research did highlight that recent aged care reforms appear to be having a positive impact overall, with significant reductions in the use of antipsychotics, sedatives and anti-seizure medications across the board.
“Our findings suggest that the government reforms may be contributing to positive changes,” Raban said. “However, there is a plateau in the decline, suggesting further improvements are possible. A persistent two-fold higher use of antipsychotics in residents with dementia and a rising trend in antidepressant use among people with dementia, highlight areas needing urgent attention.”
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
