Polypharmacy Among Older Adults with Parkinson’s Disease

In a retrospective, cross-sectional study published in the Journal of Parkinson’s Disease, researchers found that the prevalence of psychotropic polypharmacy is high among older adults with Parkinson’s disease (PD) living in nursing homes and home health settings (2016;6[1]:247-255). 

Older individuals with PD generally suffer from more than one psychiatric comorbidity, which may necessitate the use of concurrent psychotropic medications. Thus, Sandipan Bhattacharjee, PhD, and colleagues from the University of Arizona (Tucson, AZ) conducted their study using data from the 2004 National Nursing Home Survey (NNHA) and the 2007 National Home and Hospice Care Survey (NHHCS) to determine the prevalence, patterns, and predictors of psychotropic polypharmacy among the elderly in the United States. 

The analytic sample included older adults (age ≥ 65 years) with PD. In total, 93,648 residents in nursing homes and 37,439 residents in home health settings were evaluated. Researchers classified prescribed psychotropic medications as being of the following classes: antidepressants, antipsychotics, sedatives/hypnotics, and anti-anxiety medications. Concurrent use of two or more psychotropic medications was classified as psychotropic polypharmacy.

Among older individuals with PD, the nationally representative prevalence of psychotropic polypharmacy was 26.28% and 21.36%, respectively. Antidepressant usage constituted the majority of the psychotropic medication use among both nursing home (48.91%) and home health residents with PD (40.98%). Multiple logistic regression analyses revealed that specific comorbidities were significantly associated with psychotropic polypharmacy. 

The authors said these findings underscore the importance of evidence-based prescribing, especially with psychotropic medication use in older individuals with PD, in order to reduce unnecessary and potentially detrimental polypharmacy.—Amanda Del Signore