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

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Purpose

The aim of this prospective cohort study was to analyze psychotropic drug use in community-dwelling elderly people over a 3-year period and characterize those individuals most susceptible to persistent and incident use.

Methods

Data on demographics, health status, cognition, functional capacity and drug use were gathered by interviews at baseline (2004) and in three follow-ups (2005–2007) in a population-based sample of 700 community-dwelling people aged ≥75 years. Characteristics associated with persistent and incident use were identified using Cox proportional-hazards regression.

Results

At baseline, 38% (n = 269) of the participants used psychotropic drugs. Of these, 60% (n = 162) reported use in all three follow-ups, whereas 22% (n = 59) discontinued use. Among the baseline users of antipsychotics (n = 40), antidepressants (n = 83) and benzodiazepines (n = 219), respectively, 43, 51 and 55% reported use in all three follow-ups. The characteristics associated with persistent use of psychotropic drugs included concomitant use of psychotropic drugs, regular use of psychotropic drugs, increasing age and good self-rated health. Among the baseline nonusers of psychotropic drugs (n = 431), 20% (n = 88) initiated use during the follow-up. Incident use of psychotropic drugs was associated with increasing Geriatric Depression Scale scores, a Mini-Mental State Examination score ≤24, number of visits to physician ≥ 6, moderate/poor self-rated health and moderate/poor life satisfaction.

Conclusions

Psychotropic drugs, benzodiazepines in particular, are frequently used for extended periods in community-dwelling people aged ≥75 years. Individuals with multiple psychotropic drugs and a regular pattern of use are most susceptible to persistent use. Characteristics associated with incident use include depressive symptoms, cognitive decline and poor general health.

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Acknowledgments

The GeMS Study was funded by the Social Insurance Institution of Finland and City of Kuopio, Finland. In addition, financial support was obtained from the Ageing, Well-being and Technology Graduate School, University of Jyväskylä, Finland. The sponsors played no role in the design of the GeMS Study or the preparation of this manuscript. The authors are grateful to research secretary Päivi Heikura and to statistician Piia Lavikainen for their assistance with data management.

Conflicts of interest

The authors declare that they have no conflicts of interest

Author information

Authors and Affiliations

  1. Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland

    Maria Rikala & Sirpa Hartikainen

  2. School of Pharmacy/Social Pharmacy, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland

    Maria Rikala

  3. Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Turku, Finland

    Maarit Jaana Korhonen

  4. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland

    Raimo Sulkava

  5. Department of Neurology, Kuopio University Hospital, Kuopio, Finland

    Raimo Sulkava

  6. School of Pharmacy/Clinical Pharmacology and Geriatric Pharmacotherapy, University of Eastern Finland, Kuopio, Finland

    Sirpa Hartikainen

  7. Leppävirta Health Centre, Leppävirta, Finland

    Sirpa Hartikainen

Authors
  1. Maria Rikala
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  2. Maarit Jaana Korhonen
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  3. Raimo Sulkava
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  4. Sirpa Hartikainen
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Correspondence to Maria Rikala.

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Rikala, M., Korhonen, M.J., Sulkava, R. et al. Psychotropic drug use in community-dwelling elderly people—characteristics of persistent and incident users. Eur J Clin Pharmacol 67, 731–739 (2011). https://doi.org/10.1007/s00228-011-0996-5

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  • DOI: https://doi.org/10.1007/s00228-011-0996-5

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