title: The use of psychotropics and survival in demented elderly individuals.
abstract: The present study aimed to examine the use of psychotropics and its relation to survival in demented elderly persons. A random sample of 700 individuals, aged 75 years or older, was drawn from the population of Kuopio city in January 1998. A geriatrician and a nurse carried out clinical examinations of 601 individuals, of whom 137 suffered from dementia according to DSM-IV criteria. The lifespan was calculated from the date of examination in 1998 to the end of 2003. In survival analyses, subjects were divided according to psychotropic use into groups: (i) users of only one of kind of psychotropics and (ii) concomitant users of all kinds of psychotropics. Psychotropics were classified into antipsychotics, antidepressants and a group of anxiolytics and hypnotics/sedatives. Seventy-one percent (n = 97) of demented elderly individuals used a psychotropic drug. Age- and sex-adjusted survival did not differ by severity of dementia (P = 0.076) or by the diagnosis of dementia (P = 0.54). When survival was compared with nonusers of psychotropics, the hazard ratio was 2.75 (P = 0.002) for individuals who used antipsychotics as their only psychotropic medicine and 1.76 (95% confidence interval 1.09-2.86) for concomitant users of all kinds of psychotropics. The use of several psychotropics or antipsychotics is a risk factor for death in demented elderly persons.
authors.affiliation: Division of Geriatrics, Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland. sirpa.hartikainen@uku.fi
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
authors.forename: Terhi
authors.initials: T
authors.lastname: Rahkonen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Raimo
authors.initials: R
authors.lastname: Sulkava
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use*; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D011619:Psychotropic Drugs