Drug use in persons with and without Alzheimer's disease aged 90 years or more.
increasing number of persons reach very high age but few studies have investigated their drug use patterns.



to compare drug use among persons with Alzheimer's disease (AD) aged ≥90 years to persons without AD with similar age and to younger persons with AD.



register-based data were from the MEDALZ cohort including all community-dwelling persons diagnosed with AD 2005-11 in Finland. They were identified from Special Reimbursement register. One comparison person without AD was matched with age-, gender- and region of residence. Persons with AD were divided to those aged ≥90 years (N = 3,319) and <90 years (N = 63,896) at the time of AD diagnoses. Drug use was analysed during a 6-month period after AD diagnosis. Logistic regression models were constructed to compare prevalence of drug use.



compared to comparison persons without AD with similar age, persons with AD aged ≥90 years were more likely to use antipsychotics (comorbidity adjusted odds ratio [aOR] 4.84, 95% CI 4.07-5.75; CI, confidence intervals) and antidepressants (aOR 2.45, 95% CI 2.14-2.80). In addition, persons with AD used more likely preventive drugs such as statins (aOR 1.20, 95% CI 1.04-1.38) and bisphosphonates (aOR 1.33, 95% CI 1.13-1.57). Compared to younger persons with AD, those aged ≥90 years were more likely to use psychotropic drugs (55.6% vs. 48.4%, aOR 1.30, 95% CI 1.21-1.39), including antipsychotics (aOR 1.40, 95% CI 1.28-1.52) and BZDRs (aOR 1.34, 95% CI 1.25-1.45).



the vulnerable oldest persons with AD receive a substantial burden of psychotropics.
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.|School of Pharmacy, University of Eastern Finland, Kuopio, Finland.|Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.
Heidi
H
Taipale
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.|School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Marjaana
M
Koponen
Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|National Institute for Health and Welfare, Helsinki, Finland.
Antti
A
Tanskanen
School of Pharmacy, University of Eastern Finland, Kuopio, Finland.|Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland.
Anna-Maija
AM
Tolppanen
Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.|Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Jari
J
Tiihonen
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.|School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Sirpa
S
Hartikainen
D000367:Age Factors; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D011307:Drug Prescriptions; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D013997:Time Factors
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D050071:Bone Density Conservation Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
Alzheimer's disease; drug utilisation; nonagenarian; older people; psychotropic drugs