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Adverse drug reactions in elderly subjects hospitalized in a specialized dementia management unit


Kanagaratnam, Lukshe, Mahmoudi, Rachid, Novella, Jean-Luc, Jolly, Damien, Dramé, Moustapha, Trenque, Thierry


Drugs & Aging, Volume: 31, No.: 10, Pages.: 769-776

Year of Publication



Introduction: Drug prescriptions represent an actionable item in the prevention of adverse drug reactions (ADRs). The aims of this study were to identify risk factors for the occurrence of ADRs, and to describe symptoms and drug interactions. Methods: This was a longitudinal study over a period of 19 months in an acute geriatric ward specializing in the management of dementia. Independent risk factors for ADRs were identified by logistic regression. Drug interactions were also recorded. Results: In total, 293 patients were included (age 82 ± 8 years). The prevalence of ADRs was 24 %. Patients were taking 8 ± 3 drugs per day; 72 (24.6 %) were taking more than three psychotropics. The main therapeutic classes prescribed were anxiolytics and hypnotics (57.7 %), antidementia drugs (54.6 %), antidepressants (54.3 %), antithrombotics (54.0 %), angiotensin-converting enzyme inhibitors [ACEIs] or angiotensin II receptor blockers [ARBs] (37.5 %). The risk of ADRs was significantly higher in patients taking neuroleptics (odds ratio [OR] 2.04; 95 % confidence interval [CI] 1.06–3.92), ACEIs/ARBs (OR 2.07; 95 % CI 1.13–3.77) and antidementia drugs (OR 1.84; 95 % CI 1.01–3.36). The risk of serious ADRs was significantly higher in patients taking ACEIs/ARBs (OR 2.95; 95 % CI 1.40–6.21), type I, III or IV antiarrhythmics (OR 2.71; 95 % CI 1.07–6.88) or neuroleptics (OR 2.42; 95 % CI 1.09–5.40). Drug interactions were involved in 26.3 % (n = 21) of ADRs; the combination of an ADR plus a drug interaction was associated with increased severity (p = 0.02). Conclusion: Caution is needed when prescribing ACEIs/ARBs, neuroleptics, antidementia drugs, or certain types of antiarrhythmics in patients suffering from dementia. Psychotropics should be avoided because of the associated risk of ADRs and drug interactions. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)

Bibtex Citation

@article{Kanagaratnam_2014, doi = {10.1007/s40266-014-0206-0}, url = {}, year = 2014, month = {sep}, publisher = {Springer Science $mathplus$ Business Media}, volume = {31}, number = {10}, pages = {769--776}, author = {Lukshe Kanagaratnam and Rachid Mahmoudi and Jean-Luc Novella and Damien Jolly and Moustapha Dram{'{e}} and Thierry Trenque}, title = {Adverse Drug Reactions in Elderly Subjects Hospitalized in a Specialized Dementia Management Unit}, journal = {Drugs Aging} }


adverse, adverse drug reactions, antithrombotics, blockers, dementia, dementia management unit, drug, elderly patients, enzyme, geriatric patients, hospitalized patients, ii, inhibitors, psychiatric units, reactions, receptor, risk factors, side effects drug

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Cohort Study

Type of Outcomes



Hospital Inpatient Care

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime, Antipsychotics and antidepressants, Other