title: Clinical diagnosis of dementia, not presence of behavioral and psychological symptoms, is associated with psychotropic use in community-dwelling elders classified as having dementia.
abstract: Little is known about the prevalence and correlates of psychotropic use in community-dwelling elders with dementia. Baseline data from 285 community-dwelling elders with a research classification of dementia (based on a neuropsychological battery of 4 tests) and their knowledgeable informants enrolled in the observational Memory and Medical Care Study were analyzed. A total of 33.3% of subjects with a research classification of dementia were clinically diagnosed, 28.8% used at least 1 psychotropic drug, and 61.8% had at least 1 behavioral or psychological symptom of dementia (BPSD). Presence of BPSD was associated with a higher likelihood of a clinical diagnosis of dementia. Multivariate logistic regression showed a clinical diagnosis of dementia, not BPSD, was associated with psychotropic use; clinical recognition of dementia appears to be an intermediate step between presence of BPSD and prescription of psychotropics. In addition, most community-dwelling elders meeting the research criteria for dementia were not clinically diagnosed, despite contact with a physician (89%) in the previous year.
authors.affiliation: Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. doctord6226@yahoo.com
authors.forename: Ding-Cheng
authors.initials: DC
authors.lastname: Chan
authors.forename: Judith D
authors.initials: JD
authors.lastname: Kasper
authors.forename: Betty S
authors.initials: BS
authors.lastname: Black
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D003937:Diagnosis, Differential; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008396:Maryland; D001523:Mental Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008609:Mental Status Schedule; D015999:Multivariate Analysis; D011619:Psychotropic Drugs / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs