Analysis of Drug Prescription Patterns during Emergency Visits of Patients with Dementia at Risk of Aspiration and Choking

Abstract

Introduction: Health care for patients with dementia is becoming increasingly important in Japan’s super-aged society. Emergency visits due to aspiration pneumonia and choking are on the rise, particularly among older adults. Polypharmacy complicates medication management in patients with dementia and may increase the risk of aspiration and choking.

Methods: This single-center, retrospective cohort study included 89 patients with dementia presenting with urgent choking or aspiration pneumonia. Pre-admission drug use and use of medications affecting swallowing function were analyzed. Information on drug use prior to admission was collected from the medical records.

Results: Approximately 70% of those surveyed were taking five or more drugs at any given time, while 20% used 10 or more drugs. Half of patients were using medicines known to affect swallowing function, which in many cases included antipsychotics and sleeping pills.

Discussion: Polypharmacy in people with dementia may complicate medication management and increase the risk of aspiration and choking. The frequency of use of antipsychotics and sleeping pills was particularly high, and their appropriateness needs to be examined.

Conclusion: Numerous patients with dementia arriving at the emergency department due to aspiration or choking are often on multiple medications, some of which may impact swallowing function. Thus, meticulous drug selection and management are imperative for the pharmacotherapy of patients with dementia.