Psychotropic drug use in community-dwelling elderly people-characteristics of persistent and incident users.

PURPOSE: The aim of this prospective cohort study was to analyze psychotropic drug use in community-dwelling elderly people over a 3-year period and characterize those individuals most susceptible to persistent and incident use.
METHODS: Data on demographics, health status, cognition, functional capacity and drug use were gathered by interviews at baseline (2004) and in three follow-ups (2005-2007) in a population-based sample of 700 community-dwelling people aged ≥75 years. Characteristics associated with persistent and incident use were identified using Cox proportional-hazards regression.
RESULTS: At baseline, 38% (n = 269) of the participants used psychotropic drugs. Of these, 60% (n = 162) reported use in all three follow-ups, whereas 22% (n = 59) discontinued use. Among the baseline users of antipsychotics (n = 40), antidepressants (n = 83) and benzodiazepines (n = 219), respectively, 43, 51 and 55% reported use in all three follow-ups. The characteristics associated with persistent use of psychotropic drugs included concomitant use of psychotropic drugs, regular use of psychotropic drugs, increasing age and good self-rated health. Among the baseline nonusers of psychotropic drugs (n = 431), 20% (n = 88) initiated use during the follow-up. Incident use of psychotropic drugs was associated with increasing Geriatric Depression Scale scores, a Mini-Mental State Examination score ≤24, number of visits to physician ≥ 6, moderate/poor self-rated health and moderate/poor life satisfaction.
CONCLUSIONS: Psychotropic drugs, benzodiazepines in particular, are frequently used for extended periods in community-dwelling people aged ≥75 years. Individuals with multiple psychotropic drugs and a regular pattern of use are most susceptible to persistent use. Characteristics associated with incident use include depressive symptoms, cognitive decline and poor general health.