Use of anti-dementia drugs in home care and residential care and associations with neuropsychiatric symptoms: a cross-sectional study.
BACKGROUND
The number of people with dementia is increasing alongside the aging population, and most of these patients manifest with neuropsychiatric symptoms (NPS). The objective of this study was to investigate anti-dementia drug use and its associations with NPS.


METHODS
Questionnaires on demographic information, current drug use, activities of daily living and NPS were sent to all municipal home care producers and to all institutions providing long-term residential care in the South Savo Hospital District, Finland.


RESULTS
The study population comprised 2821 persons. Their mean age was 81 years and 68% were female. Dementia had been diagnosed in 31% (n = 410) in home care and in 56% (n = 774) in residential care. Anti-dementia drugs were used by 69% of patients with dementia. Hyperactivity symptoms were common in residential care patients (n = 456, 33%), while problems with mood and apathy dominated in home care patients (n = 486, 54%). In multivariate regression analysis, the mood symptoms and apathy subgroup was associated with use of an acetylcholinesterase inhibitor (AChEI) (OR 1.44; 95% Cl 1.03-2.02), memantine (OR 1.77, 95% Cl 1.15-2.72) or their combinations (OR 1.56, 95% Cl 1.03-2.34). Hyperactivity symptoms were associated with combination therapy of this type (OR 2.03, 95% Cl 1.36-2.34).


CONCLUSIONS
The use of anti-dementia drugs was common in both care settings. The use of any anti-dementia drug or combination was associated with the mood and apathy subgroup. The hyperactivity subgroup was associated with combination use of memantine and AChEI.
Mikkeli Central Hospital, Porrassalmenkatu 35-37, FI-50100, Mikkeli, Finland. marja.kuronen@esshp.fi.
Marja
M
Kuronen
Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki and Helsinki University Hospital, P. O. BOX 590, FI-00029, HUS, Helsinki, Finland. hannu.j.koponen@hus.fi.
Hannu
H
Koponen
School of Pharmacy, University of Eastern Finland, Kuopio, Finland. irma.nykanen@uef.fi.|Faculty of Health Sciences, Kuopio Research Centre of Geriatric Care, P. O. BOX 1627, Kuopio, FI-70211, Finland. irma.nykanen@uef.fi.
Irma
I
Nykänen
Mikkeli Central Hospital, Porrassalmenkatu 35-37, FI-50100, Mikkeli, Finland. pertti.karppi@gmail.com.
Pertti
P
Karppi
School of Pharmacy, University of Eastern Finland, Kuopio, Finland. sirpa.hartikainen@uef.fi.|Faculty of Health Sciences, Kuopio Research Centre of Geriatric Care, P. O. BOX 1627, Kuopio, FI-70211, Finland. sirpa.hartikainen@uef.fi.
Sirpa
S
Hartikainen
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006699:Home Care Services; D006801:Humans; D008297:Male; D008559:Memantine / Q000627:therapeutic use; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D012112:Residential Facilities / Q000379:methods*; D011795:Surveys and Questionnaires
D002800:Cholinesterase Inhibitors; D018697:Nootropic Agents; D008559:Memantine