High prevalence of psychotropic drug use among persons with and without Alzheimer׳s disease in Finnish nationwide cohort

Abstract

Psychotropic drugs are used for treatment of behavioral and psychological symptoms of dementia (BPSD) although they are associated with serious adverse drug events. Objective of our study was to investigate prevalence of psychotropic drug use one year after diagnoses of Alzheimer's disease (AD), to compare prevalence to persons without AD and to assess changes in prevalence over time. Data from the MEDALZ (Medication use and Alzheimer's disease) cohort was utilized in the study including all 69,080 community-dwelling persons with new diagnosis of AD during years 2005-2011 in Finland. Four age-, gender- and region of residence-matched persons without AD were identified for each case. Register-based data included prescription drug purchases and comorbidities from Special Reimbursement Register. Annual prevalence of psychotropic drug use one year after diagnosis was determined for each person. Psychotropic drugs were used by 53% of persons with AD compared with 33% of persons without AD during one year after diagnoses. Persons with AD were six times more likely to use antipsychotics and three times more likely to use antidepressants whereas benzodiazepine and related drug (BZDR) use was comparable between persons with and without AD. According to year of AD diagnoses during 2005-2011, antipsychotic use increased from 18% to 20% (p<0.0001) and BZDR use declined from 31% to 26% (p<0.0001) among persons with AD. Widespread utilization of psychotropic drugs was observed among persons with AD. Despite safety warnings of antipsychotic use for BPSD, antipsychotic use increased from 2005 to 2011 among newly diagnosed persons with AD in Finland.

Behavioral and psychological symptoms of dementia in older residents in long-term care facilities in Japan: a cross-sectional study

“…These classifications are similar to a previous study (Taipale et al, 2014). We also classified yokukansan, a Japanese herbal medicine originating from traditional Chinese medicine, as a psychotropic drug.…”

A Comparison of Sex Differences in Psychotropic Medication Use in Older People with Alzheimer’s Disease in the US and Finland

“…The register includes data on community-dwelling individuals (i.e., medications used in hospital or NH are not recorded). Older adults with AD have been identified from the Special Reimbursement Register [16, 25–28]. …”

Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease

“…Benzodiazepines and Z-drugs are frequently prescribed for this population, and long-term use is typical. 8,30 Pneumonia often leads to admission to hospital, 10 and patients with dementia are at increased risk of death related to pneumonia. 12,13 Although our findings need further research and confirmation, the increased risk of pneumonia should be considered when benzodiazepines and Z-drugs are prescribed to older adults with Alzheimer disease.…”