Daniela C Moga1,2,3, Heidi Taipale4,5, Anna-Maija Tolppanen4, Antti Tanskanen5,6, Jari Tiihonen5,6, Sirpa Hartikainen4,7, Qishan Wu8, Gregory A Jicha9,10, Danijela Gnjidic11. 1. Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Room 241, 789 South Limestone Street, Lexington, KY, 40536-0596, USA. daniela.moga@uky.edu. 2. Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA. daniela.moga@uky.edu. 3. Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA. daniela.moga@uky.edu. 4. School of Pharmacy, University of Eastern Finland, Kuopio, Finland. 5. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 6. Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland. 7. Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland. 8. Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA. 9. Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA. 10. Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, USA. 11. Faculty of Pharmacy and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
Abstract
AIMS: Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer's disease (AD) living in the US and Finland. METHODS: We used data collected between 2005 and 2011 as part of the National Alzheimer's Coordinating Center (NACC) in the US, and Medication use and Alzheimer's disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable logistic regression adjusted for demographics, co-morbidities, and other medications to estimate the magnitude of the association (adjusted odds ratio [aOR] with 95% confidence intervals [CIs]) according to sex. RESULTS: We included 1099 NACC participants (502 [45.68%] men, 597 [54.32%] women), and 67,049 participants from the MEDALZ cohort (22,961 [34.24%] men, 44,088 [65.75%] women). Women were more likely than men to use psychotropic medications: US, 46.2% vs. 33.1%, p < 0.001; Finland, 45.3% vs. 36.1%, p < 0.001; aOR was 2.06 (95% CI 1.58-2.70) in the US cohort and 1.38 (95% CI 1.33-1.43) in the Finnish cohort. Similarly, of the different psychotropic medications, women were more likely to use antidepressants (aOR-US: 2.16 [1.44-3.25], Finland: 1.52 [1.45-1.58]) and anxiolytics (aOR-US: 2.16 [1.83-3.96], Finland: 1.17 [1.13-1.23]) than men. CONCLUSION: Older women with AD are more likely to use psychotropic medications than older men, regardless of study population and country. Approaches to mitigate psychotropic medication use need to consider different prescribing habits observed in older women vs. men with AD.
AIMS: Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer's disease (AD) living in the US and Finland. METHODS: We used data collected between 2005 and 2011 as part of the National Alzheimer's Coordinating Center (NACC) in the US, and Medication use and Alzheimer's disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable logistic regression adjusted for demographics, co-morbidities, and other medications to estimate the magnitude of the association (adjusted odds ratio [aOR] with 95% confidence intervals [CIs]) according to sex. RESULTS: We included 1099 NACC participants (502 [45.68%] men, 597 [54.32%] women), and 67,049 participants from the MEDALZ cohort (22,961 [34.24%] men, 44,088 [65.75%] women). Women were more likely than men to use psychotropic medications: US, 46.2% vs. 33.1%, p < 0.001; Finland, 45.3% vs. 36.1%, p < 0.001; aOR was 2.06 (95% CI 1.58-2.70) in the US cohort and 1.38 (95% CI 1.33-1.43) in the Finnish cohort. Similarly, of the different psychotropic medications, women were more likely to use antidepressants (aOR-US: 2.16 [1.44-3.25], Finland: 1.52 [1.45-1.58]) and anxiolytics (aOR-US: 2.16 [1.83-3.96], Finland: 1.17 [1.13-1.23]) than men. CONCLUSION: Older women with AD are more likely to use psychotropic medications than older men, regardless of study population and country. Approaches to mitigate psychotropic medication use need to consider different prescribing habits observed in older women vs. men with AD.
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