title: Cohort profile: the Finnish Medication and Alzheimer's disease (MEDALZ) study.
abstract: The aim of the Medicine use and Alzheimer's disease (MEDALZ) study is to investigate the changes in medication and healthcare service use among persons with Alzheimer's disease (AD) and to evaluate the safety and effectiveness of medications in this group. This is important, because the number of persons with AD is rapidly growing and even though they are a particularly vulnerable patient group, the number of representative, large-scale studies with adequate follow-up time is limited.
  
  
  
  MEDALZ contains all residents of Finland who received a clinically verified diagnosis of AD between 2005 and 2011 and were community-dwelling at the time of diagnosis (N=70 719). The diagnosis is based on the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCS-ADRDA) and Diagnostic and Statistical Manual Fourth Edition (DSM-IV) criteria for Alzheimer's disease. The cohort contains socioeconomic data (education, occupational status and taxable income, 1972-2012) and causes of death (2005-2012), data from the prescription register (1995-2012), the special reimbursement register (1972-2012) and the hospital discharge register (1972-2012). Future updates are planned.The average age was 80.1 years (range 34.5-104.6 years). The majority of cohort (65.2%) was women. Currently, the average length of follow-up after AD diagnosis is 3.1 years and altogether 26 045 (36.8%) persons have died during the follow-up.
  
  
  
  Altogether 53% of the cohort had used psychotropic drugs within 1 year after AD diagnoses. The initiation rate of for example, benzodiazepines and related drugs and antidepressants began to increase already before AD diagnosis.
  
  
  
  We are currently assessing if these, and other commonly used medications are related to adverse events such as death, hip fractures, head injuries and pneumonia.
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland Research Center for Comparative Effectiveness and Patient Safety, University of Eastern Finland, Kuopio, Finland.
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Tolppanen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Heidi
authors.initials: H
authors.lastname: Taipale
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Marjaana
authors.initials: M
authors.lastname: Koponen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Piia
authors.initials: P
authors.lastname: Lavikainen
authors.affiliation: Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland National Institute for Health and Welfare, Helsinki, Finland Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Antti
authors.initials: A
authors.lastname: Tanskanen
authors.affiliation: Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jari
authors.initials: J
authors.lastname: Tiihonen
authors.affiliation: School of Pharmacy, University of Eastern Finland, Kuopio, Finland Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004341:Drug Evaluation; D016903:Drug Monitoring; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D011619:Psychotropic Drugs; D001569:Benzodiazepines
keywords: Alzheimer's disease; comorbidities; healthcare service use; medication