Abstract
ObjectivesNeuropsychiatric symptoms (NPSs) in dementia patients in nursing homes are common and often treated with psychotropic drugs. Thus far, studies on psychotropic drug use (PDU) mainly focused on elderly patients with dementia. It is important to know the prevalence and correlates of PDU in patients with young‐onset dementia (YOD) to optimize NPS treatment and reduce excess PDU in this group.DesignThe Behavior and Evolution in Young‐Onset Dementia (BEYOnD) study is a cross‐sectional study in 230 residents with YOD in eight nursing homes providing specialized YOD care. PDU was registered from medical charts. The influence of age, gender, severity, and type of dementia, NPS, and agitation on PDU was analyzed.ResultsEighty‐seven percent of the residents used psychotropic drugs, and 47% used two or more psychotropic drugs. No significant associations with age, gender, dementia subtype, and dementia severity were found. Depressive symptoms showed an association with the use of antidepressants, nighttime behavior with use of hypnotics, and verbal agitation with antipsychotics. Apathy was strongly associated with lower PDU.ConclusionsNursing home patients with YOD have a high prevalence of PDU. The association with NPS raises questions of efficacy of these drugs in managing NPS. Patients with apathy had a lower chance of using psychotropics. More research on indications and effects of psychotropic drugs is needed, as well as on (nonpharmacological) alternatives for managing challenging behavior in YOD.
Highlights
Dementia is typically regarded as a disease of old age, dementia occurs at younger age
Patients with depression had a higher risk of using antidepressants, verbal agitation resulted in a greater risk of using antipsychotics, and nighttime behavior was positively associated with the use of anxiolytics and sedatives
We found a lower prevalence of Pro Re Nata (PRN)‐prescribed antipsychotics, we found a higher PRN prescription of anxiolytic drugs compared with studies with late‐onset dementia (LOD) patients.[29,45,47]
Summary
Dementia is typically regarded as a disease of old age, dementia occurs at younger age. Young‐onset dementia (YOD) with first symptom onset before the age of 651 is recognized as an important psychosocial and medical health problem with serious consequences for patients and their families.[2,3,4]. The prevalence[4,5,6] of YOD has been estimated between 67 and 98 per 100 000 for the age of 45 to 65 years and 12 per 100 000 for the age of 30 to 44 years. In patients with young onset as well as late‐onset dementia (LOD), Alzheimer's disease is the most common cause ranging from 30% to 34% in YOD. In patients with YOD, there are larger proportions of frontotemporal dementia (FTD), alcohol‐related dementia (AlcD), and other causes of cognitive deterioration[5,8] compared with those with LOD
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