Drug use by demented and non-demented elderly people.
OBJECTIVE
to determine the use of drugs by demented and non-demented elderly people in a population, by dementia status and type, age, sex and accommodation type.


METHODS
data were obtained from the Kungsholmen project, a longitudinal community study of people over 75 in Stockholm, Sweden.


RESULTS
85% used at least one medicinal drug, and of these 12% were demented. Mean numbers of drugs used were 2.8 for demented and 3.2 for non-demented people. 45% of demented people and 38% of non-demented people used psychotropic agents. Psychotropic use was higher in women and increased with institutionalization. Antipsychotic agents were used more by demented (22%) than by non-demented (3.5%) people: this was largely explained by differences in accommodation type. The odds ratio (OR) for use of antipsychotics by those in institutions compared with those living in their own homes was 9.32. Opioids were commonly prescribed for demented people. The proportions taking opioids in those using analgesics were 42% in demented and 23% in non-demented people (OR 2.07). Laxatives were used by 18% of the demented people in institutions compared with 39% of non-demented people in institutions.


CONCLUSIONS
being in an institution had a stronger association with the use of certain drugs (e.g. psychotropics) than did dementia status. Demented people, especially those in institutions, used a large number of antipsychotics and opioids, but fewer laxatives and minor analgesics. Prescribers and institutional staff should be aware of these factors so they can optimize patient treatment.
Wills
P
P
Stockholm Gerontology Research Centre and Department of Geriatric Medicine, Karolinska Institute, Sweden.
Claesson
C B
CB
Fratiglioni
L
L
Fastbom
J
J
Thorslund
M
M
Winblad
B
B
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy / Q000453:epidemiology; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D008297:Male; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology
D014150:Antipsychotic Agents; D011619:Psychotropic Drugs