title: Nationwide study of antipsychotic use among community-dwelling persons with Alzheimer's disease in Finland.
abstract: BACKGROUND
  Antipsychotics continue to be widely used in the treatment of behavioral and psychological symptoms of dementia despite their limited effectiveness and well-known risks, including increased mortality. Our aim was to investigate the national pattern of antipsychotic use among community-dwelling persons with and without Alzheimer's disease (AD) in Finland.
  
  
  METHODS
  The Social Insurance Institution of Finland (SII) identified all persons with a verified diagnosis of AD in Finland on 31 December 2005. A control for each person with AD, matched in terms of age, sex and region of residence, was also identified. Data on reimbursed drug purchases in 2005 were extracted from the Finnish National Prescription Register. Conditional logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the use of antipsychotics.
  
  
  RESULTS
  The study population comprised 28,089 matched pairs of persons with and without AD (mean age 80.0 years, SD 6.8, 32.2% men). The annual prevalence of antipsychotic use was higher among persons with than without AD (22.1% vs. 4.4%, adjusted OR = 5.91; 95% CI 5.91-6.31). Among persons with AD, the prevalence of antipsychotic use was similar across all age groups. Of the antipsychotic users, 85.2% with AD and 51.3% without AD purchased second generation antipsychotics. Most antipsychotic prescriptions - 67.8% in the AD and 62.9% in the non-AD group - were generated in primary care situations.
  
  
  CONCLUSIONS
  One-fifth of persons with AD used antipsychotic drugs. Antipsychotic use was six times more prevalent among persons with AD than without AD. Most antipsychotics were prescribed by primary care physicians.
authors.affiliation: Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland. marja-liisa.laitinen@uef.fi
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Laitinen
authors.forename: J Simon
authors.initials: JS
authors.lastname: Bell
authors.forename: Piia
authors.initials: P
authors.lastname: Lavikainen
authors.forename: Eija
authors.initials: E
authors.lastname: Lönnroos
authors.forename: Raimo
authors.initials: R
authors.lastname: Sulkava
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000187:drug effects* / Q000523:psychology; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D012931:Social Environment
chemical_list: D014150:Antipsychotic Agents