A study from Queen’s University Belfast shows some medications “may not always be appropriate” for people living with dementia
Dr Oscar Duke spoke out after a study found an increase in mortality among people taking some drugs while having dementia(Image: BBC Morning Live)
A BBC health expert has addressed concerns following reports suggesting heightened mortality risks for certain people taking antidepressants or anti-anxiety medications. Research from Queen’s University Belfast has indicated, according to its lead researcher, that some treatments “may not always be appropriate” for individuals living with dementia.
Commonly prescribed medications including Sertraline, Citalopram and Fluoxetine, used by millions throughout the UK, have been identified as potential causes for concern. Speaking on BBC Morning Live, Dr Oscar Duke offered his perspective, highlighting particular apprehension regarding those prescribed diazepam and lorazepam.
Discussing the connection between dementia and the medications in question last month, he stated: “This will be worrying because these are common anti-depressant medicines. So lots of people will be who will be watching will be taking these medicines or know somebody who do. Millions of people take them in the in the UK every day. So do not panic is the first thing to say. This is a specific study done in Northern Ireland looking at the impact of medicines on people with dementia.”
We could live to 200, men in danger of dying out, ‘Conan the Bacterium’ can’t be stopped, and woolly mammoths will be back in 2028 – all this and more in our latest science newsletter Dr Duke highlighted that individuals are typically living longer with dementia and, given there’s no cure presently available, it poses an increasing challenge. Current estimates suggest nearly 1 million (roughly 982,000) people are living with dementia across the UK as of May 2024.
He described how the research investigated medications prescribed to dementia patients for symptom management, stating: “The reason this study was important is to try and find out the impact that things we do might have on people’s dementia. So commonly, we might give people who are struggling with their memory and all of the impacts of dementia something to help with their mood.”
Widely prescribed drugs Sertraline, Citalopram and Fluoxetine, taken by millions across the country, have been flagged as a concern(Image: Getty Images)
“You could understand that if you had dementia, it might make you feel more low, anxious, or depressed. And so this study tried to find out the impact of that, those medications that we might prescribe, an anti-depressant or an anti-anxiety tablet on your mortality and whether it affects your life expectancy.
“And they did find some changes. Now, you know, no study’s perfect. So again, not to panic. There was a very small change with the anti-depressants. So, around an 8% increase in mortality over the 10 years that they looked at in that study.” In addition to the increased mortality rate associated with these medicines, the research team also identified substantially elevated death rates among patients prescribed diazepam and lorazepam. He continued: “But for the anti-anxiety drugs, and these were drugs like things like diazepam and lorazepam, they’re often quite sedating drugs. So we might use for somebody who’s really anxious, distressed with something like dementia. There was a significant increase in mortality and people using those drugs up to about 26%.
“And we think it’s probably because as dementia is getting worse, you’re maybe more likely to need specifically those more sedating anxiety-type drugs. Of course, if you’re confused, if you’re then a bit more drowsy, you might be going to the loo in the middle of the night. You’re more likely to fall over. You’re then more likely to perhaps have an injury, break a bone, fracture a hip.
“And we know that all of those things have a poor impact on your life expectancy, particularly as you get older. And I suspect that in this study, the more severe your dementia is, the more likely you might be to be prescribed one of those sorts of medicines, particularly the more sedating type. And therefore, that might be why we see this larger increase in mortality as well. So I think not to panic if you’re somebody who’s taking one of these medicines, but worth having a conversation with your health care professional about whether it’s something that you really need and whether you’re really benefiting from it.”
Research conducted by Queen’s University Belfast, spearheaded by experts from the School of Pharmacy and Centre for Public Health, has found, according to its principal investigator, that specific medications “may not always be appropriate” for individuals living with dementia. Given dementia’s strong association with ageing and the expanding demographic of over-65s, the prevalence of dementia is projected to increase substantially. Presently, it impacts over 55 million individuals globally, with roughly 10 million fresh diagnoses occurring annually.
Dr Catherine Sinnamon, principal investigator of the study and postgraduate researcher from the School of Pharmacy, emphasised that dementia ranked among the foremost causes of mortality worldwide and “currently there is no effective treatment for the disease”. “It is therefore vitally important we look to ways to improve health and quality of life and reduce social and economic costs,” she said. Individuals living with dementia often experience additional health complications, resulting in them frequently being prescribed numerous medications.
“Sometimes these medicines may not always be appropriate. Our study aimed to uncover how antidepressant medications affect people with dementia to ensure we can provide them with the best treatment and care.”
The research team analysed prescribing trends for medications used to manage depression and anxiety in dementia sufferers, investigating the connection between these drugs and mortality risk. They examined 28,781 people living with dementia in Northern Ireland throughout a nine-year monitoring period (2012-2020), with half dying during this timeframe. The study found that antidepressants were given to 59.2% of those who died during the follow-up period, while anti-anxiety medications were prescribed to 44.8% of these individuals.
The results demonstrated a slightly increased mortality risk among dementia patients prescribed antidepressants, and a considerably higher risk in those administered anti-anxiety medications.
Dr Heather Barry, the study’s lead investigator, said the results “extend our knowledge and highlight the importance of judicious prescribing for people with dementia. It further underscores the importance of medications being regularly and thoroughly reviewed in people with dementia, whether that be by a GP or a pharmacist, to ensure they are still appropriate and are still needed,” she added.
The research was backed by personnel at the Honest Broker Service (HBS) within the Business Services Organisation Northern Ireland (BSO), with financial support provided by both the BSO and the Department of Health.