Depression Symptoms, Medication Use Among NH Residents With Dementia

Long-stay nursing home (NH) residents with dementia in Michigan had a higher prevalence of central nervous system (CNS)-active medication use as well as increased depression symptoms during the COVID-19 pandemic, according to findings published in the Journal of the American Geriatrics Society.

Between January 1, 2018, and June 30, 2021, researchers conducted a retrospective, cross-sectional study of NH residents in Michigan aged 65 years or older with a stay of 100 or more days based on Minimum Data Set assessments. Excluded participants were residents with Tourette syndrome, schizophrenia, or Huntington’s disease.

Study outcomes included depression symptoms (ie, Patient Health Questionnaire [PHQ]-9 ≥10, reflecting at least moderate depression), CNS-active medication use (eg, antipsychotics), and monthly prevalence of behavioral symptoms (ie, Agitated Reactive Behavior Scale ≥1).

Outcomes between January 1, 2018 and February 28, 2020, and March 1, 2020 and June 30, 2021 were compared for pre and post-COVID-19 respectively.

Of 37,427 Michigan long-stay NH residents with dementia, the majority were female, aged 80 years or older, White, and resided in a for-profit NH facility.

When compared to pre-COVID-19 (4.0% vs 2.9%, slope change [SC] = 0.03, P < .05), the percent of NH residents with moderate depression symptoms increased.

“Antidepressant, antianxiety, antipsychotic and opioid use increased during COVID-19 compared to pre-COVID-19 (SC = 0.41, P < .001, SC=0.17, P < .001, SC=0.07, P < .05, and SC=0.24, P < .001, respectively),” wrote researchers.

Researchers noted that there were no significant changes in behavioral symptoms or hypnotic use.

“During periods of increased isolation, facility-level policies to regularly assess depression symptoms and appropriate CNS-active medication use are warranted,” concluded study authors.

Reference:
Coe AB, Montoya A, Chang C-H, et al. Behavioral symptoms, depression symptoms, and medication use in Michigan nursing home residents with dementia during COVID-19. J Am Geriatr Soc. Published online November 8, 2022. doi:10.1111/jgs.18116