Behavioral and Psychological Symptoms of Dementia and Antipsychotic Drug Use in the Elderly with Dementia in Korean Long-Term Care Facilities.

Abstract

BackgroundBehavioral and psychological symptoms of dementia (BPSD) are known predictors of institutionalization, lower quality of life, and caregiver distress. Guidelines recommend initial management with non-pharmacological means, but antipsychotic drugs are widely used for the treatment of certain BPSD.ObjectivesThe objective of the current study is to analyze the prevalence of BPSD and antipsychotic drug use in long-term care facilities in Korea.MethodsRetrospective chart review and cross-sectional analysis was conducted with 529 residents diagnosed with dementia out of a total 835 residents in 20 long-term care facilities from October 2011 to April 2012. Basic characteristics of residents such as prevalence of BPSD and antipsychotic prescriptions were analyzed. BPSD was determined using the Neuropsychiatric Inventory-Questionnaire (NPI-Q) assessment tool, and associations with the use of antipsychotic drugs were investigated.ResultsThe mean age of the 529 residents was 81.16 ± 8.73 years; 410 (77.5 %) were female. The mean length of stay in long-term care facilities was 24.19 ± 23.06 months. The primary outcome was a prescription rate of antipsychotic medications. Of the 529 dementia residents, 143 (27 %) were prescribed antipsychotic medications (quetiapine, risperidone, and olanzapine). Agitation was the most common symptom of BPSD. Disinhibition and irritability were associated with the use of antipsychotics in a multiple logistic regression analysis [respectively P = 0.007 and 0.016 and adjusted odds ratio (range) = 0.51 (0.31–0.83) and 0.57 (0.36–0.90)].ConclusionBPSD are common in long-term care facilities in Korea. Twenty-seven percent of dementia residents in long-term care facilities in Korea were prescribed antipsychotic medications. Furthermore, antipsychotic drug use was significantly associated with disinhibition and irritability in those patients.