title: Behavioral and psychological symptoms and psychotropic drugs among people with cognitive impairment in nursing homes in 2007 and 2013.
abstract: OBJECTIVE
  The use of psychotropic drugs to treat behavioral and psychological symptoms among people with dementia has been widely questioned because of its limited efficacy and risk of harmful side-effects. The objectives of this study was to compare the prevalence of behavioral and psychological symptoms and the use of psychotropic drug treatments among old people with cognitive impairment living in geriatric care units in 2007 and 2013.
  
  
  METHODS
  Two questionnaire surveys were performed in 2007 and 2013, comprising all those living in geriatric care units in the county of Västerbotten in northern Sweden. A comparison was made between 1971 people from 2007 and 1511 people from 2013. Data were collected concerning psychotropic and antidementia drug use, functioning in the activities of daily living (ADL), cognition, and behavioral and psychological symptoms, using the Multi-Dimensional Dementia Assessment Scale (MDDAS).
  
  
  RESULTS
  Between 2007 and 2013, the use of antipsychotic drugs declined from 25.4 to 18.9 %, and of anxiolytic, hypnotic, and sedative drugs from 35.5 to 29.4 %. The prevalence of people prescribed antidepressant drugs remained unchanged while antidementia drug prescription increased from 17.9 to 21.5 %. When controlled for demographic changes, 36 out of 39 behavioral and psychological symptoms showed no difference in prevalence between the years.
  
  
  CONCLUSIONS
  The use of antipsychotic, anxiolytic, hypnotic, and sedative drugs declined considerably between 2007 and 2013 among old people with cognitive impairment living in geriatric care units. Despite this reduction, the prevalences of behavioral and psychological symptoms remained largely unchanged.
authors.affiliation: Department of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, 901 87, Umeå, Sweden. maria.gustafsson@umu.se.|Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden. maria.gustafsson@umu.se.
authors.forename: Maria
authors.initials: M
authors.lastname: Gustafsson
authors.affiliation: Department of Nursing, Umeå University, 901 87, Umeå, Sweden.|Arctic Research Centre at Umeå University, 901 87, Umeå, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Isaksson
authors.affiliation: Department of Nursing, Umeå University, 901 87, Umeå, Sweden.
authors.forename: Stig
authors.initials: S
authors.lastname: Karlsson
authors.affiliation: Department of Nursing, Umeå University, 901 87, Umeå, Sweden.|Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Sandman
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, 901 87, Umeå, Sweden.
authors.forename: Hugo
authors.initials: H
authors.lastname: Lövheim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001519:Behavior / Q000187:drug effects; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003072:Cognition Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D003704:Dementia / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
chemical_list: D002800:Cholinesterase Inhibitors; D011619:Psychotropic Drugs
keywords: Alzheimer’s disease; Antipsychotics; Behavioral and psychological symptoms; Dementia; Nursing home; Psychotropic drugs