Optimizing medications in older adults with cognitive impairment: Considerations for primary care clinicians.

OBJECTIVE: To provide primary care physicians with an approach to medication optimization in older adults with cognitive impairment. SOURCES OF INFORMATION: The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Primary Care Collaborative Memory Clinic. MAIN MESSAGE: Dementia increases the risk of medication-related adverse events and adds to the complexity and challenge of providing optimal care for these older adults. Considerations include medication adherence, appropriate therapeutic targets for comorbid conditions, minimized use of medications with potentially adverse cognitive effects, and rational use and monitoring of cognition-enhancing drugs. Medication management plans must be individualized and based on goals of care. CONCLUSION: Primary care physicians must consider many factors in optimizing medications for those with cognitive impairment.