Nearly one-third of elderly nursing home residents with dementia received antipsychotic medications, mainly atypical agents. Predisposing, enabling and need factors influenced the use of atypical agents in dementia patients. These findings suggest a need to optimize use of atypical antipsychotics in elderly dementia patients in nursing homes in the light of recent efficacy and safety data.

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The observed rate of polypharmacy dropped with increasingly stringent operational definitions for polypharmacy. The findings suggest that considerable differences arise when comparing rates of polypharmacy across studies with inconsistent operational definitions.

Over one in five elderly nursing home residents with dementia used medications with marked anticholinergic activities. The study findings suggest the need to optimize the use of anticholinergic medications in vulnerable patients with dementia given the potentially severe adverse cognitive effects of these agents.