Heidi Taipale1,2,3, Marjaana Koponen1,2, Antti Tanskanen3,4,5, Anna-Maija Tolppanen2,6, Jari Tiihonen3,4, Sirpa Hartikainen1,2. 1. Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland. 2. School of Pharmacy, University of Eastern Finland, Kuopio, Finland. 3. Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland. 4. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 5. National Institute for Health and Welfare, Helsinki, Finland. 6. Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland.
Abstract
BACKGROUND: increasing number of persons reach very high age but few studies have investigated their drug use patterns. OBJECTIVE: to compare drug use among persons with Alzheimer's disease (AD) aged ≥90 years to persons without AD with similar age and to younger persons with AD. DESIGN: register-based data were from the MEDALZ cohort including all community-dwelling persons diagnosed with AD 2005-11 in Finland. They were identified from Special Reimbursement register. One comparison person without AD was matched with age-, gender- and region of residence. Persons with AD were divided to those aged ≥90 years (N = 3,319) and <90 years (N = 63,896) at the time of AD diagnoses. Drug use was analysed during a 6-month period after AD diagnosis. Logistic regression models were constructed to compare prevalence of drug use. RESULTS: compared to comparison persons without AD with similar age, persons with AD aged ≥90 years were more likely to use antipsychotics (comorbidity adjusted odds ratio [aOR] 4.84, 95% CI 4.07-5.75; CI, confidence intervals) and antidepressants (aOR 2.45, 95% CI 2.14-2.80). In addition, persons with AD used more likely preventive drugs such as statins (aOR 1.20, 95% CI 1.04-1.38) and bisphosphonates (aOR 1.33, 95% CI 1.13-1.57). Compared to younger persons with AD, those aged ≥90 years were more likely to use psychotropic drugs (55.6% vs. 48.4%, aOR 1.30, 95% CI 1.21-1.39), including antipsychotics (aOR 1.40, 95% CI 1.28-1.52) and BZDRs (aOR 1.34, 95% CI 1.25-1.45). CONCLUSIONS: the vulnerable oldest persons with AD receive a substantial burden of psychotropics.
BACKGROUND: increasing number of persons reach very high age but few studies have investigated their drug use patterns. OBJECTIVE: to compare drug use among persons with Alzheimer's disease (AD) aged ≥90 years to persons without AD with similar age and to younger persons with AD. DESIGN: register-based data were from the MEDALZ cohort including all community-dwelling persons diagnosed with AD 2005-11 in Finland. They were identified from Special Reimbursement register. One comparison person without AD was matched with age-, gender- and region of residence. Persons with AD were divided to those aged ≥90 years (N = 3,319) and <90 years (N = 63,896) at the time of AD diagnoses. Drug use was analysed during a 6-month period after AD diagnosis. Logistic regression models were constructed to compare prevalence of drug use. RESULTS: compared to comparison persons without AD with similar age, persons with AD aged ≥90 years were more likely to use antipsychotics (comorbidity adjusted odds ratio [aOR] 4.84, 95% CI 4.07-5.75; CI, confidence intervals) and antidepressants (aOR 2.45, 95% CI 2.14-2.80). In addition, persons with AD used more likely preventive drugs such as statins (aOR 1.20, 95% CI 1.04-1.38) and bisphosphonates (aOR 1.33, 95% CI 1.13-1.57). Compared to younger persons with AD, those aged ≥90 years were more likely to use psychotropic drugs (55.6% vs. 48.4%, aOR 1.30, 95% CI 1.21-1.39), including antipsychotics (aOR 1.40, 95% CI 1.28-1.52) and BZDRs (aOR 1.34, 95% CI 1.25-1.45). CONCLUSIONS: the vulnerable oldest persons with AD receive a substantial burden of psychotropics.
Authors: Rebecca J Kamil; Dara Bakar; Matthew Ehrenburg; Scott Frankenthaler; Eric X Wei; Eric Anson; Esther Oh; Yuri Agrawal Journal: Alzheimers Dement (N Y) Date: 2018-04-07