Abstract
BACKGROUND
Polypharmacy, potentially inappropriate medications (PIMs), and drugs associated with drug-induced cognitive impairment (DICI) are highly prevalent in older adults and may affect cognitive decline.
METHODS
This observational retrospective study included 2379 patients evaluated at Ace Alzheimer Center Barcelona. Medication data were extracted from electronic health records using a large language model (LLM). Polypharmacy (≥5), hyperpolypharmacy (≥10), PIMs, and DICI drugs were analyzed across cognitive stages, Alzheimer’s disease biomarkers, ApoE subtype, and estimated glomerular filtration rate.
RESULTS
Among patients with cognitive impairment (Clinical Dementia Rating [CDR] ≥ 0.5), 67% presented polypharmacy and 21% hyperpolypharmacy. Higher odds of polypharmacy were observed across the CDR scale, while higher education showed a protective effect. Altered renal function was found in 20.8% of patients with polypharmacy. Indeed, significant differences were found between amyloid beta-positive and negative (Aβ+/Aβ−) subjects and between the whole population and subjects participating in clinical trials.
DISCUSSION
Polypharmacy is extremely common in patients attending memory clinics. LLMs could facilitate systematic structured medication reviews.
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This post is Copyright: | August 25, 2026
Neuro-Dementia