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Deprescribing for People with Dementia: A Roadmap
Ariel R. Green, Cynthia M. Boyd, Rosalphie Quiles, Andrea E. Daddato, Kathy S. Gleason, Tobie Taylor-McPhail, Aleksandra Wec, Stephanie K. Nothelle et al.. Drugs & Aging, 2025-08-26
Topic: Risk, prevention and care in population studies
People with dementia (PWD) are frequently exposed to polypharmacy and potentially inappropriate medication use, in which the risks of medication use outweigh the benefits or the medication is not aligned with treatment goals. Appropriate deprescribing of unnecessary or potentially inappropriate medications is essential to high-quality care for PWD, to avoid iatrogenic harm and improve health and well-being for patients and their care partners. In this article, we review the risks of polypharmacy in PWD and evidence for the safety and efficacy of deprescribing in this population. Building off existing deprescribing frameworks for older adults with multimorbidity and limited life expectancy, we provide a roadmap for deprescribing in PWD that addresses the unique challenges of living dementia, including the variable disease course, high prevalence of distressing behavioral symptoms, and central role of care partners. The steps include: (1) identify potential targets for deprescribing by eliciting medication-related goals and considering tradeoffs, (2) develop a tapering plan, (3) complete additional actions that are necessary before deprescribing, and (4) provide close follow-up. Lastly, we provide evidence-based strategies for communicating with patients and their care partners about deprescribing, adapted from the FRAME tool.
Key findings
- Appropriate deprescribing of unnecessary or potentially inappropriate medications is essential to high-quality care for PWD, to avoid iatrogenic harm and improve health and well-being for patients and their care partners.
- In this article, we review the risks of polypharmacy in PWD and evidence for the safety and efficacy of deprescribing in this population.
- Building off existing deprescribing frameworks for older adults with multimorbidity and limited life expectancy, we provide a roadmap for deprescribing in PWD that addresses the unique challenges of living dementia, including the variable disease course, high prevalence of distressing behavioral symptoms, and central role of care partners.
- The steps include: (1) identify potential targets for deprescribing by eliciting medication-related goals and considering tradeoffs, (2) develop a tapering plan, (3) complete additional actions that are necessary before deprescribing, and (4) provide close follow-up.
- Lastly, we provide evidence-based strategies for communicating with patients and their care partners about deprescribing, adapted from the FRAME tool.
Why it matters
This article reviews the risks of polypharmacy in people with dementia and the evidence on deprescribing, and provides a roadmap for stopping unnecessary or potentially inappropriate medications. It addresses improving care and avoiding harm, not curing or preventing dementia.
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Study details
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Drugs & Aging) |
| Journal's citation record | 1 / 4 | Drugs & Aging: journal h-index 135 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 14 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 6.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 14 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Rebecca S. Boxer: h-index 31 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40856967) |
| Free to read | 2 / 2 | Free to read |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Green, A. R., Boyd, C. M., Quiles, R., Daddato, A. E., Gleason, K. S., Taylor-McPhail, T., et al. (2025). Deprescribing for People with Dementia: A Roadmap. Drugs & Aging. https://doi.org/10.1007/s40266-025-01238-w
Vancouver
Green AR, Boyd CM, Quiles R, Daddato AE, Gleason KS, Taylor-McPhail T, et al. Deprescribing for People with Dementia: A Roadmap. Drugs & Aging. 2025. doi:10.1007/s40266-025-01238-w. PMID: 40856967.
BibTeX
@article{green2025-40856967,
author = {Green, Ariel R. and Boyd, Cynthia M. and Quiles, Rosalphie and Daddato, Andrea E. and Gleason, Kathy S. and Taylor-McPhail, Tobie and Wec, Aleksandra and Nothelle, Stephanie K. and others},
title = {{Deprescribing for People with Dementia: A Roadmap}},
journal = {Drugs \& Aging},
year = {2025},
doi = {10.1007/s40266-025-01238-w},
pmid = {40856967},
url = {https://doi.org/10.1007/s40266-025-01238-w}
}
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