Older adults in Yinzhou, China, were increasingly prescribed psychotropic medications in the year leading up to a formal dementia diagnosis, and prescribing jumped sharply in the month the diagnosis was made before leveling off over the following year, according to a retrospective study published in BMC Geriatrics.
Researchers drew on electronic health records from the Yinzhou Health Information System to assemble a population-based cohort of patients who received an incident dementia diagnosis between January 2011 and June 2021. The day of diagnosis was set as the index date, and the team tracked the monthly proportion of patients using psychotropic drugs across the twelve months before and the twelve months after that date.
The cohort comprised 3,408 adults aged 65 years and above. To characterize how prescribing changed around the diagnosis, the investigators applied an interrupt time series analysis, a statistical approach that separates gradual trend changes from abrupt shifts in level at a defined point in time.
Before diagnosis, overall psychotropic prescribing followed a steadily rising trend, with an estimated monthly increase of 0.49 percentage points (p < 0.001). The proportion of patients using these medications climbed from 13.1 percent in the twelfth month before diagnosis to 18.6 percent in the month immediately preceding it.
Immediately after the diagnosis, prescribing showed a significant level increase of 2.49 percentage points (p < 0.001), reaching 22.1 percent in the first month following the index date. During the subsequent twelve months, the trend was significantly attenuated compared with the pre-diagnosis period (β3 = −0.49, p < 0.001), meaning prescribing essentially stabilized rather than continuing to climb.
The pattern was not uniform across drug classes. After the index date, the study observed significant declines in the prescribing trend for antipsychotics (β3 = −0.48, p < 0.001), antidepressants (β3 = −0.22, p < 0.001), antiepileptics (β3 = −0.14, p < 0.001), and Z-drugs (β3 = −0.05, p = 0.007). In contrast, the trend for benzodiazepines remained unchanged (β3 = 0.12, p = 0.359), indicating that use of this sedative class did not follow the same post-diagnosis tapering seen for other psychotropics.
The authors note that psychotropic medications can pose high risks for patients with dementia, and that mapping prescribing patterns before and after the formal diagnosis may help identify clinically important windows for medication review and risk management. Their findings suggest the period surrounding diagnosis is one such window: prescribing accelerates beforehand, shifts abruptly at diagnosis, and then plateaus.
Based on these temporal patterns, the researchers conclude that the necessity and safety of all ongoing psychotropic medications should be reevaluated once dementia is diagnosed, in order to improve patient safety and quality of care. They emphasize that temporal prescribing patterns differed across drug classes, so review efforts would need to account for the distinct trajectories of antipsychotics, antidepressants, antiepileptics, Z-drugs, and benzodiazepines.
As a retrospective analysis of records from a single Chinese district, the study describes observed prescribing patterns in this cohort rather than testing the effects of any intervention, and the published results are limited to the reported time series estimates for the twelve months on either side of diagnosis.
Subject of Research: Psychotropic medication prescribing patterns before and after dementia diagnosis in older adults
Article Title: Psychotropic medication prescribing among older adults before and after dementia diagnosis: a retrospective study in Yinzhou, China
Article References: Li, C., Ling, K., Gong, Z., Zhang, Y., Zhu, D., Li, H., Lin, H., Shen, P., Shi, L., Fu, M., & Guan, X. (2026). Psychotropic medication prescribing among older adults before and after dementia diagnosis: a retrospective study in Yinzhou, China. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08606-0
Image Credits: AI Generated
DOI: 10.1186/s12877-026-08606-0
Keywords: dementia, psychotropic medications, older adults, prescribing patterns, interrupt time series analysis, electronic health records, antipsychotics, antidepressants, benzodiazepines, Z-drugs, medication review, China
News Source: Ophelia Keating. (October 29, 2026). Psychotropic drug use rises before dementia diagnosis, then stabilizes after. Scienmag.
