Polypharmacy isn’t new in senior care—but in dementia populations, it’s becoming harder to manage and riskier to ignore.

Recent research published in Alzheimer’s Research & Therapy found that more than half of individuals living with dementia are taking five or more medications. Many are also prescribed medications that may be inappropriate or carry increased risk for this population.

Dementia fundamentally changes how medications are tolerated and processed. What may be appropriate for a general geriatric population can have very different effects in someone with cognitive impairment—leading to increased sensitivity, unpredictable responses, and a higher likelihood of adverse events.

In practice, this often becomes a cycle. A medication is added to manage symptoms, side effects emerge, and additional medications are introduced to address those effects. Over time, regimens become more complex, harder to manage, and riskier for the resident.

That complexity doesn’t stay confined to the chart—it can show up across the building:

• More time-intensive med passes, increasing pressure on nursing staff
• Greater risk of medication errors with layered regimens
• Increased falls, hospitalizations, and changes in condition
• Behavioral symptoms that may be medication-related rather than disease progression

Left unaddressed, this level of complexity increases not just clinical risk, but survey exposure and strain on already stretched staff.

The goal isn’t always to reduce medications across the board. It’s to ensure that each one has a clear purpose, a measurable benefit, and a risk profile that aligns with the resident’s condition and goals of care.

In many long-term care settings such as nursing homes, these risks are mitigated by mandated Medication Regimen Reviews conducted by qualified consultant pharmacists. This increased level of clinical coordination creates a partnership among pharmacy, facility, and provider to increase accuracy, responsiveness, and help simplify that complexity. It’s a model that is increasingly being utilized in alternate senior care settings, such as assisted living, to improve outcomes and keep residents stable.

Polypharmacy in dementia isn’t going away—but unmanaged complexity shouldn’t be the norm. With the right clinical coordination and pharmacy partnership, providers can reduce risk, stabilize residents, and bring greater consistency to day-to-day care.