Psychotropic drug use in community-dwelling people with young-onset dementia: two-year course and determinants

ABSTRACTBackground:Young-onset dementia (YOD) is defined as dementia that develops before the age of 65 years. The prevalence and type of neuropsychiatric symptoms (NPS) in YOD differ from patients with late onset dementia. NPS in dementia patients are often treated with psychotropic drugs. The aim of this study was to investigate psychotropic drug use (PDU) in Dutch community-dwelling YOD patients and the association between age, gender, dementia etiology and severity, symptoms of depression, disease awareness, unmet needs, and type of NPS.Methods:Psychotropic drug use in 196 YOD patients was registered. Drugs were categorized according to the Anatomical Therapeutical Chemical classification. The association between age, gender, dementia type, dementia stage, type of NPS, depressive symptoms, disease awareness, and amount of unmet needs on total PDU was analyzed using binomial logistic regression analysis.Results:Fifty-two percent of the patients were prescribed at least one psychotropic drug; 36.2% of patients used one drug, and 12.2% used two different drugs. Antidepressants (36.2%) and antipsychotic drugs (17.3%) were the most frequently prescribed psychotropic drugs. Anti-dementia drugs were prescribed in 51.5% of the patients. Increasing age and moderate to severe depressive symptoms were positively associated with the total use of psychotropic drugs.Conclusions:Community-dwelling YOD patients have a high prevalence of PDU. More research is needed to study the association between unmet needs, NPS, and PDU, and psychosocial interventions have to be developed to limit the use of psychotropic drugs in YOD.

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Prevalence and correlates of psychotropic drug use in Dutch nursing home patients with young‐onset dementia

International Journal of Geriatric Psychiatry ◽

10.1002/gps.5116 ◽

2019 ◽

Vol 34 (8) ◽

pp. 1185-1193 ◽

Cited By ~ 2

Author(s):

Ans J.M.J. Mulders ◽

Sytse U. Zuidema ◽

Renée Leeuwis ◽

Hans Bor ◽

Frans R.J. Verhey ◽

...

Keyword(s):

Nursing Home ◽

Drug Use ◽

Psychotropic Drug ◽

Young Onset ◽

Psychotropic Drug Use ◽

Nursing Home Patients ◽

Young Onset Dementia

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Effects of a Multidisciplinary Intervention on the Presence of Neuropsychiatric Symptoms and Psychotropic Drug Use in Nursing Home Residents WithYoung-Onset Dementia: Behavior and Evolution of Young-Onset Dementia Part 2 (BEYOND-II) Study

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2018.12.032 ◽

2019 ◽

Vol 27 (6) ◽

pp. 581-589 ◽

Cited By ~ 6

Author(s):

Britt Appelhof ◽

Christian Bakker ◽

Marjolein E. de Vugt ◽

Jeannette C.L. van Duinen-van den IJssel ◽

Sandra A. Zwijsen ◽

...

Keyword(s):

Nursing Home ◽

Drug Use ◽

Psychotropic Drug ◽

Neuropsychiatric Symptoms ◽

Nursing Home Residents ◽

Multidisciplinary Intervention ◽

Young Onset ◽

Psychotropic Drug Use ◽

Young Onset Dementia

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Change in psychotropic drug use among community-dwelling people aged 75 years and older in Finland: repeated cross-sectional population studies

International Psychogeriatrics ◽

10.1017/s1041610211000718 ◽

2011 ◽

Vol 23 (8) ◽

pp. 1278-1284 ◽

Cited By ~ 11

Author(s):

Franciska Desplenter ◽

Charlotte Caenen ◽

Jolein Meelberghs ◽

Sirpa Hartikainen ◽

Raimo Sulkava ◽

...

Keyword(s):

Drug Use ◽

Psychotropic Drug ◽

Adverse Drug Events ◽

Community Dwelling ◽

Cross Sectional ◽

Psychotropic Drug Use ◽

Random Samples ◽

Antidepressant Use ◽

Status Differences ◽

Compare And Contrast

ABSTRACTBackground: Older people are at high risk of experiencing psychotropic-related adverse drug events. The objective of this study was to compare and contrast the use of psychotropic drugs among community-dwelling people aged ≥75 years in 1998 and 2004.Methods: Comparable random samples of people aged ≥75 years were extracted from the population register in Kuopio, Finland, in 1998 (n = 700) and 2003 (n = 1000). In 1998 and 2004, 523 and 700 community-dwelling people respectively participated in nurse interviews, during which demographic, diagnostic and drug use data were elicited. Logistic regression was used to compute unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of psychotropic drug use in 2004 compared to 1998.Results: The unadjusted prevalence of total psychotropic (37.3% and 38.4%, OR 1.05; 95% CI 0.83–1.33), anxiolytic, hypnotic and sedative (29.6% and 31.3%, OR 1.08, 95% CI 0.85–1.38), and antidepressant (10.7% and 11.9%, OR 1.12, 95% CI 0.78–1.61) use were similar in 1998 and 2004. There was a decrease in the unadjusted prevalence of antipsychotic use (9.2% and 5.7%, OR 0.60; 95% CI 0.39–0.93). After adjusting for socioeconomic and health status differences, there was an increase in the prevalence of total psychotropic (adjusted OR 1.31, 95% CI 1.01–1.70) and antidepressant (OR 1.59, 95% CI 1.06–2.40) use.Conclusion: The unadjusted prevalence of psychotropic drug use remained stable between 1998 and 2004. However, in adjusted analyses there was a small increase in the prevalence of any psychotropic drug use and antidepressant use specifically.

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Clinical Diagnosis of Dementia, Not Behavioral and Psychologic Symptoms, Is Associated With Psychotropic Drug Use in Community-Dwelling Elders Classified as Having Dementia

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988706298628 ◽

2007 ◽

Vol 20 (2) ◽

pp. 100-106 ◽

Cited By ~ 5

Author(s):

Ding-Chen Chan ◽

Judith D. Kasper ◽

Betty S. Black ◽

Peter V. Rabins

Keyword(s):

Drug Use ◽

Clinical Diagnosis ◽

Psychotropic Drug ◽

Community Dwelling ◽

Psychotropic Drug Use ◽

Diagnosis Of Dementia

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Psychotropic drug use in community-dwelling elderly people—characteristics of persistent and incident users

European Journal of Clinical Pharmacology ◽

10.1007/s00228-011-0996-5 ◽

2011 ◽

Vol 67 (7) ◽

pp. 731-739 ◽

Cited By ~ 20

Author(s):

Maria Rikala ◽

Maarit Jaana Korhonen ◽

Raimo Sulkava ◽

Sirpa Hartikainen

Keyword(s):

Drug Use ◽

Elderly People ◽

Psychotropic Drug ◽

Community Dwelling ◽

Psychotropic Drug Use

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The effects of medication assessment on psychotropic drug use in the community-dwelling elderly

International Psychogeriatrics ◽

10.1017/s1041610210001547 ◽

2010 ◽

Vol 23 (3) ◽

pp. 473-484 ◽

Cited By ~ 13

Author(s):

Maria Rikala ◽

Maarit Jaana Korhonen ◽

Raimo Sulkava ◽

Sirpa Hartikainen

Keyword(s):

Drug Use ◽

Psychotropic Drug ◽

Psychotropic Drugs ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

P Value ◽

Control Groups ◽

Psychotropic Drug Use ◽

And Control

ABSTRACTBackground:The study evaluated the effects of an annual medication assessment conducted as part of a Comprehensive Geriatric Assessment (CGA) on the prevalence of psychotropic drug use in community-dwelling elderly people.Methods:Randomly selected persons (n = 1000) aged ≥75 years living in the city of Kuopio, Finland were randomized to intervention and control groups. The intervention group underwent an annual (2004–2006) medication assessment as part of a CGA by physicians. Data on drug use were gathered by interviews at baseline (2004) and in three following years (2005–2007). Generalized estimating equations (GEE) were applied to explore whether the prevalence of psychotropic drug use differed between the community-dwelling participants of the intervention (n = 361) and control groups (n = 339) over time.Results:At baseline, nearly 40% of the participants used psychotropic drugs in each group. In the intervention group, the study physicians implemented 126 psychotropic drug-related changes, 39% of which were persistent after one year. The prevalence of use of psychotropic drugs, antipsychotics and anxiolytic/hypnotics did not differ between the groups over time. The prevalence of antidepressant use remained constant in the intervention group, but increased in the control group (p-value for interaction = 0.039). The prevalence of concomitant use of psychotropic drugs decreased non-significantly in the intervention group, but increased in the control group (p-value for interaction = 0.009).Conclusions:Conducting an annual medication assessment outside the usual primary health care system does not appear to reduce the prevalence of psychotropic drug use in community-dwelling elderly people. However, it may prevent concomitant use of psychotropic drugs.

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Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

BMC Nursing ◽

10.1186/1472-6955-3-3 ◽

2004 ◽

Vol 3 (1) ◽

Cited By ~ 31

Author(s):

Philippe Voyer ◽

David Cohen ◽

Sylvie Lauzon ◽

Johanne Collin

Keyword(s):

Drug Use ◽

Psychotropic Drug ◽

Older Persons ◽

Empirical Studies ◽

Community Dwelling ◽

Factors Associated ◽

Psychotropic Drug Use

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Psychotropic drug use and alcohol drinking in community-dwelling older Australian men: the CHAMP study

Drug and Alcohol Review ◽

10.1111/j.1465-3362.2012.00496.x ◽

2012 ◽

Vol 32 (2) ◽

pp. 218-222 ◽

Cited By ~ 12

Author(s):

Jenni Ilomäki ◽

Danijela Gnjidic ◽

Sarah N. Hilmer ◽

David G. Le Couteur ◽

Vasi Naganathan ◽

...

Keyword(s):

Drug Use ◽

Psychotropic Drug ◽

Alcohol Drinking ◽

Community Dwelling ◽

Psychotropic Drug Use

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Behavior and Evolution of Young ONset Dementia part 2 (BEYOND-II) study: an intervention study aimed at improvement in the management of neuropsychiatric symptoms in institutionalized people with young onset dementia

International Psychogeriatrics ◽

10.1017/s1041610217000941 ◽

2017 ◽

Vol 30 (3) ◽

pp. 437-446 ◽

Cited By ~ 6

Author(s):

J. C. L. van Duinen-van den IJssel ◽

B. Appelhof ◽

S. A. Zwijsen ◽

M. Smalbrugge ◽

F. R. J. Verhey ◽

...

Keyword(s):

Quality Of Life ◽

Psychotropic Drug ◽

Unmet Needs ◽

Neuropsychiatric Symptoms ◽

Care Program ◽

Community Dwelling ◽

Care Needs ◽

Young Onset ◽

Young Onset Dementia

ABSTRACTBackground:Both neuropsychiatric symptoms (NPS) and psychotropic drug use (PDU) are common in institutionalized People with Young Onset Dementia (PwYOD) and can produce negative outcomes such as reduced quality of life and high workload. In community-dwelling PwYOD, NPS are found to be associated with unmet care needs. This emphasizes the importance of a care program for the management of NPS in institutionalized PwYOD that also addresses unmet care needs and PDU. The objectives of the Behavior and Evolution of Young ONset Dementia part 2 (BEYOND-II) study are to develop a care program for the management of NPS in institutionalized PwYOD and to evaluate its effectiveness.Methods:The care program consists of an educational program combined with an intervention to manage NPS with the following five steps: the evaluation of psychotropic drug prescription, detection, analysis (including the detection of unmet needs), treatment and the evaluation of NPS. A stepped wedge design will be used to evaluate its effectiveness. The primary outcomes are agitation and aggression and other NPS. The secondary outcomes are PDU, quality of life, the workload of nursing staff and job satisfaction. Additionally, a process analysis and a cost-consequence analysis will be conducted.Conclusions:The study protocol of the Beyond-II study describes the development, implementation and evaluation of a care program for the management of NPS in institutionalized PwYOD. This care program provides a structured method for the management of NPS, in which unmet needs and PDU are also addressed.

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