Abstract
BackgroundElderly persons make greater use of psychotropic drugs, but there are few international studies on social differences in the use of these medications. The aim of this study is to examine social differences in the use of psychotropic drugs among persons aged 65–74 years in the International Mobility in Aging Study (IMIAS).MethodsThe sample consisted of 1,995 participants in the IMIAS 2012 baseline study in Saint-Hyacinthe (Canada), Kingston (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). During home visits, all medication taken by the participants in the previous 15 days was recorded. We then used the Anatomical Therapeutic Chemical classification system to code psychotropic drugs as anxiolytics, sedatives, hypnotics (ASH); antidepressants (ADP); or analgesics, antiepileptics, or antiparkinsonians (AEP). Prevalence ratios for psychotropic drug use according to sex, education, income, and occupation were estimated by fitting a Poisson regression and controlling for demographic and health covariates.ResultsPsychotropic drug use was higher among Canadian participants than among those living outside Canada. Prevalence of AEP drug use was higher for women than men in the Canadian and Latin American sites. In Tirana, antidepressant drugs were rarely used. Socioeconomic differences varied among sites. In the Canadian cities, low socioeconomic standing was associated with higher frequency of psychotropic drug use. In the Latin American cities, elderly people with high education and income levels showed a higher level of antidepressant drug use, while people with manual occupations had a higher use of AEP drugs. In Tirana, ASH drug use was higher among those with low income.ConclusionAn inverse association was observed between socioeconomic standing and psychotropic drug use in Canada, while the opposite was true in Latin America. Albania was notable for an absence of antidepressant use and greater use of ASH drugs among low-income groups.
Highlights
Persons make greater use of psychotropic drugs, but there are few international studies on social differences in the use of these medications
Studies on elderly persons in the United States and in Northern Europe have found no association between income and education and psychotropic drug use [11,12,13], while in Sweden psychotropic drugs were more often prescribed by psychiatrists to those with the highest levels of education [14]
Among elderly persons in Israel, use of anxiolytics, sedatives, and hypnotics was negatively associated with level of education, while that of antidepressants increased with level of education [1]
Summary
Persons make greater use of psychotropic drugs, but there are few international studies on social differences in the use of these medications. Inappropriate use has been reported: for example, while antidepressants were being taken by 20 % of participants with depressive symptoms, they were being taken by 5–12 % of those without depressive symptoms [2] This could be related to the multiple indications of these drugs, ranging from depression to sleep disorders and neuropathic pain [3, 4]. In Quebec, the use of anxiolytics, sedatives, and hypnotics, as well as of antidepressants, has been negatively associated with income and education levels of elderly persons [9, 10]. In Australia, women, older adults, and persons with lower education were more likely to be antidepressant users [15] All of these studies were conducted in elderly populations of high-income countries
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