title: Use of antidepressants among community-dwelling persons with Alzheimer's disease: a nationwide register-based study.
abstract: BACKGROUND
  Antidepressants are used to treat depression and behavioral symptoms in Alzheimer's disease (AD), although their effectiveness has been questioned and evidence about the risks is accumulating. The objective of this study was to compare antidepressant use among persons with and without AD in Finland.
  
  
  METHODS
  The Social Insurance Institution of Finland (SII) identified all persons with a verified diagnosis of AD in Finland on December 31, 2005. For each person with AD a comparison person matched for age, sex and region of residence was also identified. Data on reimbursed drug purchases in 2005 were extracted from the Finnish National Prescription Register (FNPR). Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for antidepressant use.
  
  
  RESULTS
  The study sample comprised of 28,089 matched pairs of persons with and without AD (mean age 80.0 SD 6.8, 32.2% men).The prevalence of antidepressant use was higher among persons with AD than without AD (29.4% vs. 10.7%, OR = 3.54; 95% CI: 3.38, 3.70). Among the persons with AD, the prevalence of antidepressant use increased with time since AD diagnosis but not with age. Overall, 90.4% of antidepressant users with AD were co-dispensed anti-dementia drugs.
  
  
  CONCLUSIONS
  The antidepressant use was three times more prevalent among persons with AD compared to those without. Though the antidepressant selection was largely consistent with clinical practice guidelines, the high prevalence of use warrants further investigation given the uncertain effectiveness and adverse events related to these drugs.
authors.affiliation: Kuopio Research Centre of Geriatric Care,University of Eastern Finland,Kuopio,Finland.
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Laitinen
authors.affiliation: Institute of Public Health and Clinical Nutrition,Department of Geriatrics,University of Eastern Finland,Kuopio,Finland.
authors.forename: Eija
authors.initials: E
authors.lastname: Lönnroos
authors.affiliation: Kuopio Research Centre of Geriatric Care,University of Eastern Finland,Kuopio,Finland.
authors.forename: J Simon
authors.initials: JS
authors.lastname: Bell
authors.affiliation: Kuopio Research Centre of Geriatric Care,University of Eastern Finland,Kuopio,Finland.
authors.forename: Piia
authors.initials: P
authors.lastname: Lavikainen
authors.affiliation: Institute of Public Health and Clinical Nutrition,Department of Geriatrics,University of Eastern Finland,Kuopio,Finland.
authors.forename: Raimo
authors.initials: R
authors.lastname: Sulkava
authors.affiliation: Kuopio Research Centre of Geriatric Care,University of Eastern Finland,Kuopio,Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003863:Depression / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D057187:Independent Living / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012042:Registries; D012737:Sex Factors
chemical_list: D000928:Antidepressive Agents
keywords: antidepressive agents