The study explores the effects of deprescribing antihypertensive medications on cognitive function in nursing home residents, focusing on those aged 65 and older. Using data from the U.S. Department of Veterans Affairs, the study examined two groups: residents who reduced or discontinued antihypertensive medications and those who continued stable medication use. The main objective was to assess whether deprescribing led to significant changes in cognitive outcomes, particularly given the common practice of polypharmacy and potential adverse effects of antihypertensive drugs, such as falls or orthostatic hypotension.

Results showed that deprescribing antihypertensive medications was associated with a reduced risk of cognitive decline, particularly among residents with dementia. Over two years, those in the deprescribing group demonstrated a slower rate of cognitive decline compared to stable users. The odds of progressing to a worse cognitive function category decreased by 12% in the deprescribing group, while residents with dementia saw a 16% reduction in cognitive decline. These findings support the potential cognitive benefits of deprescribing in this population.

The study emphasizes the need for individualized, patient-centered approaches to deprescribing, especially in nursing homes where residents often face multiple comorbidities. Despite the positive results, the authors note the need for further research to confirm the benefits and address any potential harms of deprescribing. Additional data is crucial to guide medication management strategies for older adults, particularly those with cognitive impairment or dementia.

Overall, this study contributes to the ongoing debate on the appropriate use of antihypertensive medications in older adults, particularly those residing in long-term care facilities. It suggests that deprescribing could offer a viable strategy to mitigate cognitive decline, but careful consideration of individual health risks remains essential for optimizing treatment plans.