title: A Comparison of Sex Differences in Psychotropic Medication Use in Older People with Alzheimer's Disease in the US and Finland.
abstract: Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer's disease (AD) living in the US and Finland.
  
  
  
  We used data collected between 2005 and 2011 as part of the National Alzheimer's Coordinating Center (NACC) in the US, and Medication use and Alzheimer's disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable logistic regression adjusted for demographics, co-morbidities, and other medications to estimate the magnitude of the association (adjusted odds ratio [aOR] with 95% confidence intervals [CIs]) according to sex.
  
  
  
  We included 1099 NACC participants (502 [45.68%] men, 597 [54.32%] women), and 67,049 participants from the MEDALZ cohort (22,961 [34.24%] men, 44,088 [65.75%] women). Women were more likely than men to use psychotropic medications: US, 46.2% vs. 33.1%, p < 0.001; Finland, 45.3% vs. 36.1%, p < 0.001; aOR was 2.06 (95% CI 1.58-2.70) in the US cohort and 1.38 (95% CI 1.33-1.43) in the Finnish cohort. Similarly, of the different psychotropic medications, women were more likely to use antidepressants (aOR-US: 2.16 [1.44-3.25], Finland: 1.52 [1.45-1.58]) and anxiolytics (aOR-US: 2.16 [1.83-3.96], Finland: 1.17 [1.13-1.23]) than men.
  
  
  
  Older women with AD are more likely to use psychotropic medications than older men, regardless of study population and country. Approaches to mitigate psychotropic medication use need to consider different prescribing habits observed in older women vs. men with AD.
authors.affiliation: Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Room 241, 789 South Limestone Street, Lexington, KY, 40536-0596, USA. daniela.moga@uky.edu.|Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA. daniela.moga@uky.edu.|Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA. daniela.moga@uky.edu.
authors.forename: Daniela C
authors.initials: DC
authors.lastname: Moga
authors.affiliation: 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.
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Tolppanen
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Tanskanen
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Tiihonen
authors.affiliation: 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
authors.affiliation: Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA.
authors.forename: Qishan
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA.|Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Jicha
authors.affiliation: Faculty of Pharmacy and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
authors.forename: Danijela
authors.initials: D
authors.lastname: Gnjidic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D012727:Sex Characteristics; D014481:United States / Q000453:epidemiology
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs