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While previous studies have examined specific types of problematic medication use in PWD, we sought to characterize a broad spectrum of medication misuse and overuse among community\u2010dwelling PWD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included community\u2010dwelling adults aged \u226566 in the Health and Retirement Study from 2008 to 2018 linked to Medicare and classified as having dementia using a validated algorithm. Medication usage was ascertained over the 1\u2010year prior to an HRS interview date. Potentially problematic medications were identified by: (1) medication overuse including over\u2010aggressive treatment of diabetes\/hypertension (e.g., insulin\/sulfonylurea with hemoglobin A1c\u2009&lt;\u20097.5%) and medications inappropriate near end of life based on STOPPFrail and (2) medication misuse including medications that negatively affect cognition and medications from 2019 Beers and STOPP Version 2 criteria. To contextualize, we compared medication use to people without dementia through a propensity\u2010matched cohort by age, sex, comorbidities, and interview year. We applied survey weights to make our results nationally representative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1441 PWD, median age was 84 (interquartile range\u2009=\u200978\u201389), 67% female, and 14% Black. Overall, 73% of PWD were prescribed \u22651 potentially problematic medication with a mean of 2.09 per individual in the prior year. This was notable across several domains, including 41% prescribed \u22651 medication that negatively affects cognition. Frequently problematic medications included proton pump inhibitors (PPIs), non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs), opioids, antihypertensives, and antidiabetic agents. Problematic medication use was higher among PWD compared to those without dementia with 73% versus 67% prescribed \u22651 problematic medication (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and mean of 2.09 versus 1.62 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Community\u2010dwelling PWD frequently receive problematic medications across multiple domains and at higher frequencies compared to those without dementia. Deprescribing efforts for PWD should focus not only on potentially harmful central nervous system\u2010active medications but also on other classes such as PPIs and NSAIDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18463","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T17:47:31Z","timestamp":1686160051000},"page":"3086-3098","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Medication misuse and overuse in community\u2010dwelling persons with dementia"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7947-3008","authenticated-orcid":false,"given":"W. James","family":"Deardorff","sequence":"first","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"San Francisco Veterans Affairs Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bocheng","family":"Jing","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"San Francisco Veterans Affairs Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5997-4406","authenticated-orcid":false,"given":"Matthew E.","family":"Growdon","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"San Francisco Veterans Affairs Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Yaffe","sequence":"additional","affiliation":[{"name":"San Francisco Veterans Affairs Medical Center  San Francisco California USA"},{"name":"Department of Psychiatry and Behavioral Sciences University of California, San Francisco  San Francisco California USA"},{"name":"Department of Neurology University of California, San Francisco  San Francisco California USA"},{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. John","family":"Boscardin","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"San Francisco Veterans Affairs Medical Center  San Francisco California USA"},{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1165-5558","authenticated-orcid":false,"given":"Kenneth S.","family":"Boockvar","sequence":"additional","affiliation":[{"name":"Division of Gerontology, Geriatrics, and Palliative Care University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9564-9480","authenticated-orcid":false,"given":"Michael A.","family":"Steinman","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"San Francisco Veterans Affairs Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12638"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010014\u20100192\u20104"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0479"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u201011\u2010200712040\u201000006"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201075888\u20108"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12712"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2022.01.083"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2023.02.015"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165757"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574884710666150812141525"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2019\u201000198"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23\u2010S006"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13054"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.0677"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098616670798"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102019\u2010029172"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17291"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010170905"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/workar\/wax032"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1204629"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000945"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001188"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu145"},{"key":"e_1_2_11_26_1","unstructured":"American Geriatrics Society | Choosing Wisely. 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