title: Incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease among community-dwelling persons.
abstract: BACKGROUND
  Behavioural and psychological symptoms of dementia are frequently treated with antipsychotics.
  
  
  OBJECTIVE
  To determine the incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease.
  
  
  METHODS
  Cohort of all community-dwellers in Finland diagnosed with Alzheimer's disease in 2005 and matched controls. All antipsychotics dispensed between 1995 and 2009 were extracted from the Finnish National Prescription Register.
  
  
  RESULTS
  Altogether 1996/6087 (32.8%) persons with Alzheimer's disease initiated antipsychotic use. The incidence of antipsychotic use was fivefold among persons with Alzheimer's disease compared with controls, started to increase 2-3 years before diagnosis and was highest during the first 6 months after diagnosis.
  
  
  CONCLUSIONS
  A distinct increase in antipsychotic initiations occurs in the same time window as Alzheimer's disease diagnosis.
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland marjaana.koponen@uef.fi.
authors.forename: Marjaana
authors.initials: M
authors.lastname: Koponen
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Tolppanen
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Taipale
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Tanskanen
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Tiihonen
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Kristina
authors.initials: K
authors.lastname: Johnell
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Johan
authors.initials: J
authors.lastname: Fastbom
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Riitta
authors.initials: R
authors.lastname: Ahonen
authors.affiliation: Marjaana Koponen, MSc, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Anna-Maija Tolppanen, PhD, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland; Heidi Taipale, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland; Antti Tanskanen, Phil Lic, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and National Institute for Health and Welfare, Helsinki, Finland; Jari Tiihonen, MD, PhD, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland and National Institute for Health and Welfare, Helsinki, Finland; Kristina Johnell, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden and Stockholm Gerontology Research Center, Stockholm, Sweden; Johan Fastbom, MD, PhD, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Riitta Ahonen, PhD, Sirpa Hartikainen, MD, PhD, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D012042:Registries
chemical_list: D014150:Antipsychotic Agents