PREVALENCE AND PREDICTORS OF POTENTIALLY INAPPROPRIATE MEDICATIONS (PIMS) IN SAUDI OLDER ADULTS WITH MOOD AND ANXIETY DISORDERS: A SYSTEMATIC REVIEW

Background: Potentially inappropriate medications(PIMs)are common in older adults and are associate with adverse drug events, hospitalization, and increased health-care costs. Older adults with mood and anxiety disorders may be at heightened risk due to psychotropic exposure, multimorbidity, and polypharmacy. Objective: To synthesize Saudi evidence on (i) the prevalence of PIM exposure among adults aged 60 years and (ii) consistent predictors of PIM exposure, with particular attention to psychiatric populations and mood/anxiety-related subgroups when reported. Methods: We conducted a PRISMA 2020-compliant systematic review of peer-reviewed observational studies conducted in Saudi Arabia. PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and the Saudi Digital Library were searched from inception through March 2025.Studies reporting extractable prevalence of 1 PIM and/or adjusted predictors using explicit criteria(e.g., AGS Beers; STOPP/START) were eligible. Risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist for prevalence studies and the NIH quality assessment tools for observational studies. Due to substantial heterogeneity across settings and criteria versions, findings were synthesized narratively; where appropriate, descriptive sample-size weighted preval ence summaries were reported.