title: Caregiver and care recipient characteristics as predictors of psychotropic medication use in community-dwelling dementia patients.
abstract: The current practice of prescribing psychotropic medication for the management of dementia-related behavioral disturbances is under substantial debate. Using Pearlin's stress process model as theoretical underpinning, the aim of this investigation is to identify caregiver and care recipient characteristics as predictors of anxiolytic, antipsychotic, and antidepressant use among community-dwelling dementia patients. We hypothesized that caregiving burden and patient characteristics, particularly behavior disturbances and pain, would be positively associated with psychotropic medication use.
  
  
  
  Data for this exploratory, cross-sectional study were drawn from the baseline assessment of the Resources for Enhancing Alzheimer's Caregiver Health II trial. Only participants with full baseline information were examined (N = 598). Caregiver characteristics, such as confidence managing problematic behaviors, and care recipient characteristics including pain, problem behaviors, cognitive impairment, and functional impairment, were examined in relation to care recipient psychotropic medication use.
  
  
  
  Contrary to our hypothesis, behavioral disturbances and burden associated with these disturbances were not significantly associated with psychotropic use. Rather, caregiver characteristics such as race and overall vigilance, and care recipient characteristics such as cognitive status, functional status, and pain were significantly associated with the use of psychotropic medication. Findings differed by class of medication.
  
  
  
  These exploratory findings suggest the utility of a holistic approach to understanding the factors associated with pharmacotherapy among community-dwelling elders with dementia. Significant associations between caregiver characteristics and care recipient psychotropic medication use suggest that educating caregivers in non-pharmacologic strategies hold promise for a more balanced biopsychosocial approach to maintaining dementia patients in the community.
authors: a Center for Social Epidemiology and Population Health, School of Public Health , University of Michigan , Ann Arbor , MI , USA.
authors: Elsie L
authors: EL
authors: Grace
authors: b School of Social Work , University of Michigan , Ann Arbor , MI , USA.
authors: Louis D
authors: LD
authors: Burgio
authors: c Alabama Research Institute on Aging, University of Alabama , Tuscaloosa , AL , USA.|d Department of Psychology , University of Alabama , Tuscaloosa , AL , USA.
authors: Rebecca S
authors: RS
authors: Allen
authors: e Curry School of Education , University of Virginia , Charlottesville , VA , USA.
authors: Jamie
authors: J
authors: DeCoster
authors: a Center for Social Epidemiology and Population Health, School of Public Health , University of Michigan , Ann Arbor , MI , USA.
authors: Allison E
authors: AE
authors: Aiello
authors: f School of Nursing , University of Michigan , Ann Arbor , MI , USA.
authors: Donna L
authors: DL
authors: Algase
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use*
chemical_list: D011619:Psychotropic Drugs
keywords: analgesics; dementia caregiving; psychotropics