Alta prevalencia de consumo de neurolépticos en las personas ancianas con demencia

Abstract

Background and objectives The management of psychological and behavioural symptoms associated with dementia frequently requires the use of neuroleptic drugs. The objective of this study was to determine the prevalence, characteristics and possible differential factors of people aged ≥ 65 years with dementia who take or not neuroleptic drugs. The subgroup with Alzheimer disease was analysed. Patients and methods Five-hundred and fifteen patients aged ≥ 65 years with dementia were prospectively evaluated. Data were collected on sociodemographic variables, type of dementia, Barthel Index (BI), Lawton Index (LI), Mini Mental State Exam (MMSE), Charlson Index, treatment with neuroleptic, antidepressants, benzodiazepines and non-benzodiazepine hypnotic-sedatives drugs, specific dementia treatments, vascular risk factors and comorbidities. The stage and severity of dementia were evaluated by the Global Deterioration Scale (GDS), creating two groups: Mild-moderate (GDS 3, 4 and 5) and severe (GDS 6 and 7) disease. Results There were 364 women (70%) and 151 men, with a mean age of 81±6 years, of whom 10.1% were institutionalized. Two hundred and seventy patients (52.5%) had mild-moderate disease and 245 had severe disease (47.5%). Neuroleptic drugs were being taken by 233 (45.2%) patients. In the multivariate analysis, neuroleptic drug use was associated with male gender, institutionalization, worse LI scores, more severe dementia and not having heart failure. The subgroup with Alzheimer disease was associated with worse IB and not having arterial hypertension. Conclusion A high percentage of elderly patients with dementia are treated with neuroleptic drugs. There are significant differences in the prescription of neuroleptic drugs according to patient sociodemographic characteristics, severity of dementia and comorbidities.