title: Exposure to psychotropics in the French older population living with dementia: a nationwide population-based study.
abstract: Little is known about the level of psychotropic chronic exposure in all patients living with dementia. The aim of the study was to quantify chronic psychotropic exposure in older adults with dementia compared with the general population of the same age.
  
  
  
  This prospective cohort study was conducted in France between 2009 and 2011. Aged at least 65 years, 10,781,812 individuals (440,215 of them with dementia) either community based or nursing home residents were included. The numbers of single or combined prescriptions, per year for antipsychotics, antidepressants, anxiolytics, or hypnotics were measured.
  
  
  
  Of patients with dementia, 15.5% are exposed to antipsychotics compared with 2.2% of the age-matched population (relative risk [RR] = 6.44, 95% confidence interval [CI] [6.39-6.48]), 39.5% to antidepressants compared with 12.6% (RR = 4.10, 95% CI [.4.07-4.12]), and 39.6% to anxiolytics or hypnotics compared with 26.9% (RR = 1.74, 95% CI [1.72-1.75]). Among older adults with dementia, 13.8% simultaneously consumed at least three psychotropics. All class age of older patients with dementia is more exposed to all psychotropics except for long-acting benzodiazepines. During the study period, chronic anxiolytic/hypnotic and antipsychotic exposure slightly decreased in population with dementia while chronic exposure to antidepressant drugs tended to increase.
  
  
  
  This nationwide, population-based, drug-used study showed for the first time that older patients with dementia are chronically overexposed not only to antipsychotics but also to psychotropics.
authors.affiliation: APHP, DHU FAST, Groupe Hospitalier Pitié Salpêtrière - Charles Foix, Centre de Gériatrie, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Breining
authors.affiliation: OMEDIT Ile de France, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, UMR 1123 INSERM, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Bonnet-Zamponi
authors.affiliation: APHP, DHU FAST, Groupe Hospitalier Pitié Salpêtrière - Charles Foix, Centre de Gériatrie, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06 and CNRS, UMR 8256 B2A, Paris, France.
authors.forename: Lorène
authors.initials: L
authors.lastname: Zerah
authors.affiliation: HAS, Saint-Denis la Plaine, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Micheneau
authors.affiliation: HAS, Saint-Denis la Plaine, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Riolacci-Dhoyen
authors.affiliation: French Institute for Public Health Surveillance, Saint-Maurice, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Chan-Chee
authors.affiliation: Régime Social des Indépendants, Saint Denis la Plaine, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Deligne
authors.affiliation: Caisse Centrale de la Mutualité Sociale Agricole, Bagnolet, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Harlin
authors.affiliation: APHP, DHU FAST, Groupe Hospitalier Pitié Salpêtrière - Charles Foix, Centre de Gériatrie, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06 and CNRS, UMR 8256 B2A, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Boddaert
authors.affiliation: APHP, DHU FAST, Groupe Hospitalier Pitié Salpêtrière - Charles Foix, Centre de Gériatrie, Paris, France.|Sorbonne Universités, UPMC Univ Paris 06 and CNRS, UMR 8256 B2A, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Verny
authors.affiliation: HAS, Saint-Denis la Plaine, France.
authors.forename: Armelle
authors.initials: A
authors.lastname: Leperre-Desplanques
mesh_terms: D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D005602:France; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000627:therapeutic use*
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs; D001569:Benzodiazepines
keywords: Alzheimer disease; antidepressant; antipsychotics; dementia; psychotropics