Abstract
BackgroundThe number of people with dementia is increasing alongside the aging population, and most of these patients manifest with neuropsychiatric symptoms (NPS). The objective of this study was to investigate anti-dementia drug use and its associations with NPS.MethodsQuestionnaires on demographic information, current drug use, activities of daily living and NPS were sent to all municipal home care producers and to all institutions providing long-term residential care in the South Savo Hospital District, Finland.ResultsThe study population comprised 2821 persons. Their mean age was 81 years and 68 % were female. Dementia had been diagnosed in 31 % (n = 410) in home care and in 56 % (n = 774) in residential care. Anti-dementia drugs were used by 69 % of patients with dementia. Hyperactivity symptoms were common in residential care patients (n = 456, 33 %), while problems with mood and apathy dominated in home care patients (n = 486, 54 %). In multivariate regression analysis, the mood symptoms and apathy subgroup was associated with use of an acetylcholinesterase inhibitor (AChEI) (OR 1.44; 95 % Cl 1.03–2.02), memantine (OR 1.77, 95 % Cl 1.15–2.72) or their combinations (OR 1.56, 95 % Cl 1.03-2.34). Hyperactivity symptoms were associated with combination therapy of this type (OR 2.03, 95 % Cl 1.36–2.34).ConclusionsThe use of anti-dementia drugs was common in both care settings. The use of any anti-dementia drug or combination was associated with the mood and apathy subgroup. The hyperactivity subgroup was associated with combination use of memantine and AChEI.
Highlights
The number of people with dementia is increasing alongside the aging population, and most of these patients manifest with neuropsychiatric symptoms (NPS)
Study design and participants We identified with the help of local and regional authorities all public home care units (n = 21) providing regular care and all institutions (n = 68) giving longterm residential care to older people, including both private and municipal residential care facilities, nursing homes and long-term wards in municipal hospitals
Dementia had been physician-diagnosed in 1184 patients (43.8 %), 56.0 % in residential care and 31.1 % in home care
Summary
The number of people with dementia is increasing alongside the aging population, and most of these patients manifest with neuropsychiatric symptoms (NPS). Dementia contributes one-tenth of the years spent with disability in people aged over 60 years. This is more than the proportion of stroke, cardiovascular disease or cancer [1]. The annual costs of dementia are estimated to be 600 billion US dollars [3]. Neuropsychiatric symptoms (NPS) occur in 80–90 % of persons with dementia [4].
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