Deprescribing to Reduce Injurious Falls among Older Adults with Dementia

Dr. Elizabeth Phelan, professor (Gerontology and Geriatric Medicine) has received funding from the National Institute on Aging (NIA) IMPACT (IMbedded Pragmatic Alzheimer's disease and AD-Related Dementias Clinical Trials) Collaborative Pilot Grant Program for the study “Deprescribing to Reduce Injurious Falls among Older Adults with Dementia.”

Falls among older adults are a major public health concern, and older people living with dementia (PLWD) have disproportionately higher fall rates. The use of medications that affect the central nervous system (CNS) is a key modifiable risk factor for falls. CNS-active medications are often considered potentially inappropriate for older adults, especially for older PLWD, and guidelines recommend avoiding their use. However, use remains common and is higher among older PLWD compared to those without dementia. Few deprescribing interventions have targeted older PLWD in primary care.

The objective is to adapt an evidence-based, health-system-embedded, patient-centered deprescribing intervention called STOP-FALLS, which focuses on reducing use of CNS-active medications among older adults living with dementia, and conduct a pilot study for an embedded pragmatic clinical trial with older people living with dementia, their care partner(s), and their primary care providers.

Dr. Phelan is director of the Northwest Geriatrics Workforce Enhancement Center and founding director of the UW Medicine Fall Prevention Clinic.