People with Alzheimer’s disease and other forms of dementia end up in hospital emergency rooms 1.4 million times a year, a new study shows.

Together, they make up nearly 7% of all emergency visits for any reason by people over age 65. And compared with their peers who don’t have dementia, these patients have twice the rate of seeking emergency care after an accident or a behavioral or mental health crisis, the researchers show.

With about 6 million Americans currently estimated to have dementia, the study suggests there’s a lot of opportunity to prevent future emergency visits by better supporting dementia caregivers, the researchers say.

The findings, published in JAMA Neurology, could help inform efforts to support family caregivers and nursing facility staff in reducing patients’ risks of injury, and preventing the agitation, aggression, and distressing behaviors that people with dementia can experience, says lead author Lauren B. Gerlach, a geriatric psychiatrist at Michigan Medicine, the University of Michigan’s academic medical center.

Once a person with dementia is in the emergency department, it can be a very disorienting experience, Gerlach says. “This is especially true in the context of a busy ED where visits can last many hours and patients may have difficulty understanding what is occurring or communicating their needs,” she says. “Even routine blood draws from unfamiliar staff can be a very scary experience for a patient with advanced dementia.”

To make matters worse, behavioral symptoms common in this group can lead to treatment with potentially dangerous sedative medications.

Emergency department patients with dementia received antipsychotic medications at more than twice the rate as other emergency patients over age 65 during their visit, the study shows. Such drugs, often used to sedate people with dementia and calm their behavioral symptoms, can carry major risks if used long-term—including increasing the risk of fall accidents and death as highlighted in warnings from the US Food and Drug Administration.

Long after the emergency has ended, the concern is that these newly started antipsychotic and sedative medications in could then continue to be prescribed long-term, putting patients with dementia at further risk, says Gerlach.

Read the full article about emergency room visits for people with dementia by Kara Gavin at Futurity.