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Dementia, neuropsychiatric symptoms, and the use of psychotropic drugs among older people who receive domiciliary care: a cross-sectional study

Published online by Cambridge University Press:  20 November 2013

Jon N. Wergeland ,
Geir Selbæk ,
Lisbeth D. Høgset ,
Ulrika Söderhamn  and
Øyvind Kirkevold
Jon N. Wergeland*
Affiliation:
Norwegian Centre for Research, Education and Service Development, Vestfold Hospital Trust, Tønsberg, Norway Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
Geir Selbæk
Affiliation:
Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway Akershus University Hospital, Lørenskog, Norway
Lisbeth D. Høgset
Affiliation:
Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
Ulrika Söderhamn
Affiliation:
Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
Øyvind Kirkevold
Affiliation:
Norwegian Centre for Research, Education and Service Development, Vestfold Hospital Trust, Tønsberg, Norway Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway Faculty of Health, Care and Nursing, Gjøvik University College, Gjøvik, Norway
*
Correspondence should be addressed to: Jon N. Wergeland, PhD, University of Agder, Serviceboks 422, 4604 Kristiansand, Norway. Phone: +4793216030; Fax: +4738141301. Email: [email protected].
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Abstract

Background:

The objective of this study was to (a) determine the prevalence of cognitive impairment, dementia, and neuropsychiatric symptoms (NPSs) among home-dwelling people, 70 years and older (70+ years), who receive domiciliary care, and (b) describe their use of psychotropic drugs. Few studies have investigated dementia among people receiving in-home care.

Methods:

A sample (N = 1,000) representative of people aged 70+ years receiving domiciliary care was randomly recruited for participation. A standardized interview with the participants and their next of kin were performed using well-established assessment scales. Two clinical experts independently diagnosed dementia according to ICD-10 criteria.

Results:

Of the 415 participants (41.5%) with dementia according to ICD-10 criteria, 19.5% had a dementia diagnosis known to the patient themselves, their caregiver, or health workers in the domiciliary care service. In the previous month, 72.1% exhibited NPSs (21.1% rated as clinically significant), with depression (47.5%), apathy (33.7%), anxiety (33.0%), and irritability (31.1%) being the most common. Psychotropic drugs were regularly used by 40.1% of the sample. Antidepressants (p = 0.001) and cognitive enhancers (p < 0.001) were more often given to people with dementia than to those without dementia.

Conclusions:

Dementia and NPSs are highly prevalent among people who receive domiciliary care, and diagnostic disclosure is low. People with dementia constitute a distinct group with respect to NPSs and psychotropic drug use. Early detection and correct diagnosis might increase the understanding of their everyday challenges and enable families to alleviate consequences of dementia and NPSs.

Keywords

BPSDcognitive impairmentcommunity dwellingdomiciliary caremedicationolder people
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 3 , March 2014 , pp. 383 - 391
Copyright
Copyright © International Psychogeriatric Association 2013 

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