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Psychotropic drug use in relation to mental disorders and institutionalization among 95-year-olds: a population-based study

Published online by Cambridge University Press:  28 March 2011

Eva Lesén ,
Anders Carlsten ,
Ingmar Skoog ,
Margda Waern ,
Max Petzold  and
Anne Börjesson-Hanson
Eva Lesén*
Affiliation:
Nordic School of Public Health, Gothenburg, Sweden
Anders Carlsten
Affiliation:
Medical Products Agency, Uppsala, Sweden
Ingmar Skoog
Affiliation:
Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Margda Waern
Affiliation:
Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Max Petzold
Affiliation:
Nordic School of Public Health, Gothenburg, Sweden
Anne Börjesson-Hanson
Affiliation:
Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
*
Correspondence should be addressed to: Eva Lesén, Nordic School of Public Health, Box 12133, SE-402 42 Gothenburg, Sweden. Phone: +46 31 693 944; Fax: +46 31 691 777. Email: [email protected].
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Abstract

Background: The prevalence of psychotropic drug use is high among the elderly, but research on how psychotropic drugs are used among individuals aged 90 years and older is limited. An increased knowledge on this topic may contribute to improved prescribing patterns in this vulnerable population. The aim of this study was to assess the use of psychotropic drugs in relation to mental disorders and institutionalization among 95-year-olds and to identify use of potentially inappropriate psychotropic drugs.

Methods: All 95-year-olds born in 1901–1903 living in nursing homes or community settings in Gothenburg, Sweden were invited to participate. The response rate was 65% and 338 95-year-olds were examined (263 women, 75 men). Psychotropic drug use in relation to mental disorders and institutionalization was assessed. Information on drug use was collected primarily from multi-dose drug dispensing lists. Participants were examined by trained psychiatrists using the Comprehensive Psychopathological Rating Scale and a battery of cognitive tests. Dementia, depression, anxiety and psychotic disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R).

Results: Sixty percent of the 95-year-old participants used psychotropic drugs; hypnotics were most common (44%). Potentially inappropriate psychotropics were observed in one third (33%). Antidepressants were used by 7% of the participants without dementia who fulfilled criteria for a depressive disorder, while 56% used hypnotics and 30% used anxiolytics.

Conclusions: The high prevalence of psychotropic drug use and the nonspecific nature of these treatments among 95-year-olds indicate a need for improvement in prescribing patterns.

Keywords

psychotropic drugsdrug utilizationmental disordersdementiadepressionnonagenarians
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 8 , October 2011 , pp. 1270 - 1277
Copyright
Copyright © International Psychogeriatric Association 2011

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