Abstract
BackgroundPsychotropic drugs are widely used among old people with dementia but few studies have described long-term treatment in this group of patients. The purpose of this study was to explore the long-term use of psychotropic drugs in old people with dementia.MethodsData on psychotropic drug use, functioning in the activities of daily living (ADL), cognitive function and behavioral and psychological symptoms were collected at baseline and six months later, using the Multi-Dimensional Dementia Assessment Scale (MDDAS). The data were collected in 2005–2006. Detailed data about the prescribing of psychotropic drugs were collected from prescription records. This study was conducted in 40 specialized care units in northern Sweden, with a study population of 278 people with dementia.ResultsAt the start of the study, 229 of the participants (82%) were prescribed at least one psychotropic drug; 150 (54%) used antidepressants, 43 (16%) used anxiolytics, 107 (38%) used hypnotics and sedatives, and 111 (40%) used antipsychotics. Among the baseline users of antidepressants, anxiolytics, hypnotics and sedatives and antipsychotics, 67%, 44%, 57% and 57% respectively, still used the same dose of the same psychotropic drug after six months. Associations were found between behavioral and psychological symptoms and different psychotropic drugs.ConclusionPsychotropic drug use was high among people with dementia living in specialized care units and in many cases the drugs were used for extended periods. It is very important to monitor the effects and adverse effects of the prescribed drug in this frail group of people.
Highlights
Psychotropic drugs are widely used among old people with dementia but few studies have described long-term treatment in this group of patients
The inappropriate use of drugs has been associated with an increased risk of hospitalization among old people [3] and studies show that up to 30% of hospital admissions are directly connected to drug-related problems [4,5]
Many older people with dementia and neuropsychiatric symptoms can be withdrawn from chronic antipsychotic treatment without deterioration, some people could benefit from continuing their antipsychotic medication [11]
Summary
Psychotropic drugs are widely used among old people with dementia but few studies have described long-term treatment in this group of patients. The purpose of this study was to explore the long-term use of psychotropic drugs in old people with dementia. Of particular concern is the high risk of adverse effects among old people treated with psychotropic drugs. These drugs are widely used among people with dementia [7,8] despite the fact that this group is at risk of the adverse cognitive effects of drugs with anticholinergic properties, such as antipsychotics and certain antihistamines [8,9]. Many psychotropic drugs are considered inappropriate, or should be used for a limited period only, or with caution among older people [19]
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