Skip header and navigation

Refine By

   MORE

9 records – page 1 of 1.

Anticholinergic drug use and its association with self-reported symptoms among older persons with and without diabetes.

https://arctichealth.org/en/permalink/ahliterature298928
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Publication Type
Journal Article
Date
Apr-2019
Author
Niina-Mari Inkeri
Merja Karjalainen
Maija Haanpää
Hannu Kautiainen
Juha Saltevo
Pekka Mäntyselkä
Miia Tiihonen
Author Affiliation
School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Source
J Clin Pharm Ther. 2019 Apr; 44(2):229-235
Date
Apr-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Cholinergic Antagonists - adverse effects - therapeutic use
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus - epidemiology
Female
Finland
Humans
Independent living
Male
Practice Patterns, Physicians' - statistics & numerical data
Primary Health Care
Self Report
Surveys and Questionnaires
Abstract
Anticholinergic drug use has been associated with a risk of central and peripheral adverse effects. There is a lack of information on anticholinergic drug use in persons with diabetes. The aim of this study is to investigate anticholinergic drug use and the association between anticholinergic drug use and self-reported symptoms in older community-dwelling persons with and without diabetes.
The basic population was comprised of Finnish community-dwelling primary care patients aged 65 and older. Persons with diabetes were identified according to the ICD-10 diagnostic codes from electronic patient records. Two controls adjusted by age and gender were selected for each person with diabetes. This cross-sectional study was based on electronic primary care patient records and a structured health questionnaire. The health questionnaire was returned by 430 (81.6%) persons with diabetes and 654 (73.5%) persons without diabetes. Data on prescribed drugs were obtained from the electronic patient records. Anticholinergic drug use was measured according to the Anticholinergic Risk Scale. The presence and strength of anticholinergic symptoms were asked in the health questionnaire.
The prevalence of anticholinergic drug use was 8.9% in the total study cohort. There were no significant differences in anticholinergic drug use between persons with and without diabetes. There was no consistent association between anticholinergic drug use and self-reported symptoms.
There is no difference in anticholinergic drug use in older community-dwelling persons with and without diabetes. Anticholinergic drug use should be considered individually and monitored carefully.
PubMed ID
30315583 View in PubMed
Less detail

Chronic pain among community-dwelling elderly: a population-based clinical study.

https://arctichealth.org/en/permalink/ahliterature282167
Source
Scand J Prim Health Care. 2016 Jun;34(2):159-64
Publication Type
Article
Date
Jun-2016
Author
Susanna Rapo-Pylkkö
Maija Haanpää
Helena Liira
Source
Scand J Prim Health Care. 2016 Jun;34(2):159-64
Date
Jun-2016
Language
English
Publication Type
Article
Keywords
Acetaminophen - therapeutic use
Aged
Aged, 80 and over
Analgesics, Non-Narcotic - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Chronic Disease - epidemiology
Chronic Pain - drug therapy - epidemiology - etiology - psychology
Cross-Sectional Studies
Fatigue - psychology
Female
Finland - epidemiology
House Calls
Humans
Independent living
Loneliness - psychology
Male
Neuralgia - complications
Quality of Life
Sex Distribution
Surveys and Questionnaires
Abstract
To present the occurrence, characteristics, etiology, interference, and medication of chronic pain among the elderly living independently at home.
A total of 460 subjects in three cohorts aged 75, 80 and 85 years respectively received visits by communal home-care department nurses for a cross-sectional survey. Of them, 175 had chronic (duration = 3 months) pain with an average intensity of = 4/10 and/or = moderate interference in daily life.
Clinical assessment was performed for consenting subjects to define the location, intensity, etiology, type, interference and medications of chronic pain.
According to home visits, elderly people with chronic pain rated their health and mobility worse and felt sadder, lonelier and more tired than those without chronic pain. A geriatrician made clinical assessments for 106 patients with chronic pain in 2009-2013. Of them, 66 had three, 35 had two and 5 had one pain condition. The worst pain was musculoskeletal in 88 (83%) of patients. Pain was pure nociceptive in 61 (58%), pure neuropathic in 9 (8%), combined nociceptive and neuropathic pain in 34 (32%), and idiopathic in 2 (2%) patients. On a numerical rating scale from 0 to 10, the mean and maximal intensity of the worst pain was 5.7 and 7.7, respectively, while the mean pain interference was 5.9. Mean pain intensity and maximal pain intensity decreased by age. Duration of pain was longer than 5 years in 51 (48%) patients. Regular pain medication was used by 82 (77%) patients, most commonly paracetamol or NSAIDs. Although pain limited the lives of the elderly with chronic pain, they were as satisfied with their lives as those without chronic pain.
Elderly people in our study often suffered from chronic pain, mostly musculoskeletal pain, and the origin of pain was neuropathic in up to 40% of these cases. However, elderly people with chronic pain rarely used the medications specifically for neuropathic pain. Based on increased loneliness, sadness and tiredness, as well as decreased subjective health and mobility, the quality of life was decreased among those with chronic pain compared with those without pain. KEY POINTS It is known that chronic pain is one of the most common reasons for general practice consultations and is more common in women than men. In our study using detailed clinical examinations, up to 40% of patients with chronic pain in cohorts aged 75, 80 and 85 years suffered from neuropathic pain. However, only a few elderly people with chronic pain used medications specifically for chronic pain, which may be due to side effects or non-willingness to experiment with these drugs. Elderly people with chronic pain rated their health and mobility to be worse and felt sadder, lonelier and more tired but were not less satisfied with their lives than those without chronic pain.
Notes
Cites: JAMA. 2003 Nov 12;290(18):2435-4214612480
Cites: Pain. 1996 Sep;67(1):29-348895228
Cites: Pain. 2015 Mar;156(3):521-725599240
Cites: Eur J Pain. 2002;6(5):375-8512160512
Cites: JAMA. 2014 Aug 27;312(8):825-3625157726
Cites: Pain Med. 2013 Nov;14(11):1664-7224118796
Cites: Br J Anaesth. 2013 Jul;111(1):13-823794640
Cites: J Pain Symptom Manage. 2009 Aug;38(2 Suppl):S4-S1419671470
Cites: Drugs Aging. 2015 Sep;32(9):737-4226363908
Cites: Clin Interv Aging. 2013;8:37-4623355774
Cites: Ann Pharmacother. 2005 Jan;39(1):11-615598966
Cites: Scand J Prim Health Care. 2015;33(4):243-5126553225
Cites: Scand J Prim Health Care. 2013 Jun;31(2):73-823621352
Cites: Age Ageing. 2005 Sep;34(5):462-616043446
Cites: Br J Gen Pract. 2007 Aug;57(541):630-517688757
Cites: Age Ageing. 2013 Mar;42 Suppl 1:i1-5723420266
Cites: JAMA. 2002 Feb 27;287(8):1022-811866651
Cites: Arch Gerontol Geriatr. 2013 Jan-Feb;56(1):285-923022058
PubMed ID
27065337 View in PubMed
Less detail

The effect of comprehensive geriatric assessment on anticholinergic exposure assessed by four ranked anticholinergic lists.

https://arctichealth.org/en/permalink/ahliterature283602
Source
Arch Gerontol Geriatr. 2017 Jan - Feb;68:195-201
Publication Type
Article
Author
Pasi Lampela
Heidi Taipale
Piia Lavikainen
Sirpa Hartikainen
Source
Arch Gerontol Geriatr. 2017 Jan - Feb;68:195-201
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cholinergic Antagonists
Drug Utilization - statistics & numerical data
Female
Finland
Follow-Up Studies
Geriatric Assessment - methods
Humans
Independent living
Male
Outcome Assessment (Health Care)
Abstract
Older people often use multiple drugs, and some of them have anticholinergic activity. Anticholinergic drugs may cause adverse reactions, and therefore their use should be limited. To identify anticholinergic load, several ranked lists with different drugs and scoring systems have been developed and used widely in research. We investigated, if a comprehensive geriatric assessment (CGA) decreased the anticholinergic drug score in a 4-year period. We used four different anticholinergic ranked lists to determine the anticholinergic score and to describe how the results differ depending on the list used.
We analyzed data from population-based intervention study, in which a random sample of 1000 persons aged =75 years were randomized to either an intervention group or a control group. Those in the intervention group underwent CGA including medication assessment annually between 2004 and 2007. Current medication use was assessed annually. The anticholinergic load was calculated by using four ranked lists of anticholinergic drugs (Boustani's, Carnahan's, Chew's and Rudolph's) for each person and for each year.
CGA had no statistically significant effect on anticholinergic exposure during the 4-year follow-up, but improvements towards more appropriate medication use were observed especially in the intervention group. However, age, gender and functional comorbidity index were associated to higher anticholinergic exposure, depending on the list used.
Repeated CGAs may result as more appropriate anticholinergic medication use. The selection of the list may affect the results and therefore the selection of the list is important.
PubMed ID
27837709 View in PubMed
Less detail

Glycemic control and health-related quality of life among older home-dwelling primary care patients with diabetes.

https://arctichealth.org/en/permalink/ahliterature293508
Source
Prim Care Diabetes. 2017 Dec; 11(6):577-582
Publication Type
Journal Article
Date
Dec-2017
Author
Anna-Kaisa Aro
Merja Karjalainen
Miia Tiihonen
Hannu Kautiainen
Juha Saltevo
Maija Haanpää
Pekka Mäntyselkä
Author Affiliation
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Finland; Rantakylä Health Center, Siunsote, Finland. Electronic address: koistine@student.uef.fi.
Source
Prim Care Diabetes. 2017 Dec; 11(6):577-582
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Aging
Biomarkers - blood
Blood Glucose - metabolism
Cognition
Cross-Sectional Studies
Diabetes Mellitus - blood - diagnosis - psychology - therapy
Female
Finland
Geriatric Assessment
Glycated Hemoglobin A - metabolism
Humans
Independent living
Male
Mental health
Mental Status and Dementia Tests
Mobility Limitation
Predictive value of tests
Primary Health Care
Quality of Life
Risk factors
Self Care - methods
Time Factors
Treatment Outcome
Abstract
To evaluate the health-related quality of life (HRQoL) and functional capacity in relation to glycemic control among older home-dwelling primary care patients.
Electronic patient records were used to identify 527 people over 65 years with diabetes. Of these, 259 randomly selected subjects were invited to a health examination and 172 of them attended and provided complete data. The participants were divided into three groups based on the HbA1c: good (HbA1c57mmol/mol (N=29)) glycemic control. HRQoL was measured with the EuroQol EQ-5D questionnaire. Functional and cognitive capacity and mental well-being were assessed with the Lawton Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15).
EQ-5D scores for good, intermediate and poor glycemic control were 0.78; 0.74 and 0.70, p=0.037. Sub-items of mobility (p=0.002) and self-care were the most affected (p=0.031). Corresponding trend was found for IADL, p=0.008. A significant correlation was found between MMSE scores and HbA1c.
Older primary care home-dwelling patients with diabetes and poorer glycemic control have lower functional capacity and HRQoL, especially in regard to mobility and self-care.
PubMed ID
28754430 View in PubMed
Less detail

Impact of opioid initiation on antipsychotic and benzodiazepine and related drug use among persons with Alzheimer's disease.

https://arctichealth.org/en/permalink/ahliterature300965
Source
Int Psychogeriatr. 2018 07; 30(7):947-956
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
07-2018
Author
Aleksi Hamina
Piia Lavikainen
Antti Tanskanen
Anna-Maija Tolppanen
Jari Tiihonen
Sirpa Hartikainen
Heidi Taipale
Author Affiliation
Kuopio Research Centre of Geriatric Care,University of Eastern Finland,Kuopio,Finland.
Source
Int Psychogeriatr. 2018 07; 30(7):947-956
Date
07-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Alzheimer Disease - drug therapy - epidemiology - psychology
Analgesics, Opioid - administration & dosage
Antipsychotic Agents - therapeutic use
Benzodiazepines - therapeutic use
Cognition - drug effects
Female
Finland - epidemiology
Humans
Independent Living - psychology - statistics & numerical data
Interrupted Time Series Analysis
Male
Medication Adherence - psychology - statistics & numerical data
Pharmacoepidemiology
Prevalence
Registries - statistics & numerical data
Risk assessment
Risk factors
Abstract
ABSTRACTBackground:We analyzed the impact of opioid initiation on the prevalence of antipsychotic and benzodiazepine and related drug (BZDR) use among community-dwelling persons with Alzheimer's disease (AD).
We utilized the register-based Medication use and Alzheimer's disease (MEDALZ) cohort for this study. We included all community-dwelling persons diagnosed with AD during 2010-2011 in Finland initiating opioid use (n = 3,327) and a matched cohort of persons not initiating opioids (n = 3,325). Interrupted time series analyses were conducted to compare the prevalence of antipsychotic and BZDR use in 30-day periods within six months before opioid initiation to 30-day periods six months later.
Before opioid initiation, prevalence of antipsychotic use among opioid initiators was 13.3%, 18.3% at opioid initiation, and 17.3% six months later. Prevalences of BZDR use were 27.1% six months prior, 28.9% at opioid initiation, and 26.9% six months later. After opioid initiation, antipsychotic and BZDR use declined by 0.3 percentage points (pps, 95% confidence interval 0.1-0.5) and 0.4 pps (0.2-0.7) per month, respectively, until the end of the follow-up. Compared to persons not initiating opioid use, opioid initiation immediately resulted in an increase in prevalence of 1.9 pps (0.9-2.8) for antipsychotics and of 1.6 pps (0.9-2.2) for BZDR use. However, in total there was a comparative decrease of 0.5 pps (0.3-0.8) per month for antipsychotics and of 0.4 pps (0.2-0.6) for BZDR use until the end of the follow-up.
Our results suggest that opioid initiation may reduce antipsychotic and BZDR use among persons with AD.
PubMed ID
29559009 View in PubMed
Less detail

Neuropathic Pain Among Community-Dwelling Older People: A Clinical Study in Finland.

https://arctichealth.org/en/permalink/ahliterature271986
Source
Drugs Aging. 2015 Sep;32(9):737-42
Publication Type
Article
Date
Sep-2015
Author
Susanna Rapo-Pylkkö
Maija Haanpää
Helena Liira
Source
Drugs Aging. 2015 Sep;32(9):737-42
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chronic Pain - drug therapy - epidemiology
Female
Finland - epidemiology
Humans
Independent living
Male
Neuralgia - drug therapy - epidemiology
Abstract
Neuropathic pain is more common among older people than in the general population, and the efficacy of medical treatment often remains unsatisfactory.
The aim of this study was to assess the presence, diagnostic certainty, etiology and treatment of neuropathic pain in community-dwelling older people with chronic pain.
Independently living older people aged 75, 80 and 85 years subject to communal preventive home visits with chronic pain were invited to a clinical pain examination by a geriatrician.
Overall, 106 patients consented to participate in the clinical study. Neuropathic pain was diagnosed in 51 (48%) patients, with 75% of pain states definite and 25% probable neuropathic pain. The most common etiology was degenerative disease of the spinal column causing radiculopathy. At the study visit, 11 patients (22% of neuropathic pain patients) were receiving medication that was demonstrated to be effective against neuropathic pain. The geriatrician recommended a trial of a new medicine for 17 patients, but only six continued the medication going forward.
Neuropathic pain was surprisingly common in our cohort. Finding effective pain medication is challenging due to comorbidities, possible side effects, and vulnerability in older age. Other pain management methods should be considered.
PubMed ID
26363908 View in PubMed
Less detail

Risk of head and traumatic brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease: a nationwide matched cohort study.

https://arctichealth.org/en/permalink/ahliterature291878
Source
Alzheimers Res Ther. 2017 Aug 01; 9(1):59
Publication Type
Journal Article
Date
Aug-01-2017
Author
Heidi Taipale
Marjaana Koponen
Antti Tanskanen
Piia Lavikainen
Reijo Sund
Jari Tiihonen
Sirpa Hartikainen
Anna-Maija Tolppanen
Author Affiliation
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, PO Box 1627, 70211, Kuopio, Finland. heidi.taipale@uef.fi.
Source
Alzheimers Res Ther. 2017 Aug 01; 9(1):59
Date
Aug-01-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - epidemiology
Antidepressive Agents - therapeutic use
Case-Control Studies
Cohort Studies
Craniocerebral Trauma - complications - diagnosis - epidemiology
Depression - drug therapy - epidemiology
Female
Finland
Humans
Independent living
Male
Middle Aged
Proportional Hazards Models
Psychiatric Status Rating Scales
Risk factors
Abstract
Antidepressant use has been associated with an increased risk of falling, but no studies have been conducted on whether antidepressant use is associated with an increased risk of head injuries which often result from falling among older persons. The objective of this study was to investigate the risk of head and brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer's disease.
A matched cohort study was conducted by comparing new antidepressant users (n?=?10,910) with two matched nonusers (n?=?21,820) in the MEDALZ study cohort. The MEDALZ cohort includes all community-dwelling persons newly diagnosed with Alzheimer's disease between 2005 and 2011 in Finland. Incident antidepressant users were identified based on register-based dispensing data from the Prescription register with a 1-year washout period for antidepressant use. Nonusers were matched with users based on age, gender, and time since Alzheimer's disease diagnosis. The outcome events were defined as any head injuries and traumatic brain injuries based on diagnoses in Hospital Discharge and Causes of Death registers. Propensity score adjusted Cox proportional hazard models were utilized. Sensitivity analyses with case-crossover design were conducted. All registers are linkable with unique personal identification numbers assigned for each resident.
Antidepressant use was associated with an increased risk of head injuries (age-adjusted event rate per 100 person-years 2.98 (95% confidence interval (CI) 2.49-3.06) during use and 2.43 (95% CI 2.06-2.35) during nonuse, adjusted hazard ratio (HR) 1.35, 95% CI 1.20-1.52) and traumatic brain injuries (age-adjusted event rate per 100 person-years 1.33 (95% CI 1.13-1.53) during use and 1.10 (95% CI 1.00-1.20) during nonuse, adjusted HR 1.26, 95% CI 1.06-1.50). The risk was highest during the first 30 days of use (HR 1.71, 95% CI 1.10-2.66 for head injuries; HR 2.06, 95% CI 1.12-3.82 for traumatic brain injuries) and remained at an elevated level for head injuries for over 2 years of use. In case-crossover analyses, antidepressant use was consistently associated with a higher risk of head injuries.
Antidepressant use was associated with an increased risk of the most severe outcomes, head and brain injuries, in persons with Alzheimer's disease. Antidepressant use should be carefully considered and the association confirmed in future studies.
Notes
Cites: Int J Clin Pract. 2009 Jul;63(7):1085-94 PMID 19570125
Cites: Ann Pharmacother. 2012 Jul-Aug;46(7-8):917-28 PMID 22811347
Cites: J Trauma Acute Care Surg. 2015 Sep;79(3):449-54 PMID 26535433
Cites: J Alzheimers Dis. 2015 ;49(1):211-20 PMID 26444790
Cites: Eur J Clin Nutr. 2015 Feb;69(2):205-10 PMID 25226820
Cites: Int J Geriatr Psychiatry. 2017 Jan;32(1):94-101 PMID 26924266
Cites: Clin Epidemiol. 2016 Oct 11;8:363-371 PMID 27785101
Cites: NeuroRehabilitation. 2007;22(5):341-53 PMID 18162698
Cites: Hum Psychopharmacol. 2004 Mar;19(2):135-9 PMID 14994325
Cites: J Am Geriatr Soc. 2006 Oct;54(10):1590-5 PMID 17038079
Cites: CNS Neurosci Ther. 2011 Dec;17(6):620-8 PMID 22070192
Cites: Eur Neuropsychopharmacol. 2014 Nov;24(11):1729-37 PMID 25453487
Cites: Int Psychogeriatr. 2015 Apr;27(4):669-72 PMID 25412711
Cites: J Am Geriatr Soc. 2003 Sep;51(9):1213-8 PMID 12919232
Cites: Multivariate Behav Res. 2011 May;46(3):399-424 PMID 21818162
Cites: BMJ. 2011 Aug 02;343 :d4551 PMID 21810886
Cites: Clin Epidemiol. 2013 Aug 07;5:277-85 PMID 23950660
Cites: Psychosomatics. 2014 Nov-Dec;55(6):536-47 PMID 25262043
Cites: J Head Trauma Rehabil. 2015 Nov-Dec;30(6):E9-17 PMID 25629257
Cites: J Clin Psychopharmacol. 2012 Apr;32(2):218-24 PMID 22367651
Cites: Am J Alzheimers Dis Other Demen. 2011 Feb;26(1):10-28 PMID 21282274
Cites: J Gerontol A Biol Sci Med Sci. 2007 Oct;62(10):1172-81 PMID 17921433
Cites: BMC Med Inform Decis Mak. 2015 Mar 25;15:21 PMID 25890003
Cites: Arch Gerontol Geriatr. 2006 Mar-Apr;42(2):217-24 PMID 16125808
Cites: Age Ageing. 2011 Jan;40(1):49-54 PMID 21087990
Cites: Drugs Aging. 2010 Apr 1;27(4):337-49 PMID 20359263
Cites: Neurology. 1984 Jul;34(7):939-44 PMID 6610841
Cites: BMJ Open. 2013 Jan 07;3(1):null PMID 23299113
Cites: J Gerontol A Biol Sci Med Sci. 2011 Dec;66(12):1384-92 PMID 21934126
Cites: PLoS One. 2013;8(3):e59124 PMID 23527106
PubMed ID
28764750 View in PubMed
Less detail

Systemic Estrogen Use and Discontinuation After Alzheimer's Disease Diagnosis in Finland 2005-2012: A Nationwide Exposure-Matched Cohort Study.

https://arctichealth.org/en/permalink/ahliterature297698
Source
Drugs Aging. 2018 11; 35(11):985-992
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
11-2018
Author
Anna-Maija Tolppanen
Miia Tiihonen
Heidi Taipale
Marjaana Koponen
Antti Tanskanen
Piia Lavikainen
Jari Tiihonen
Sirpa Hartikainen
Author Affiliation
School of Pharmacy, University of Eastern Finland, PL 1627, 70211, Kuopio, Finland. anna-maija.tolppanen@uef.fi.
Source
Drugs Aging. 2018 11; 35(11):985-992
Date
11-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Alzheimer Disease - psychology
Cognitive Dysfunction - etiology
Cohort Studies
Estrogens - administration & dosage
Female
Finland - epidemiology
Humans
Independent living
Middle Aged
Prevalence
Abstract
It is unknown whether cognitive status or diagnosed cognitive decline affects estrogen use.
We assessed how common systemic estrogen use was among community-dwellers with Alzheimer's disease (AD) and a matched comparison cohort without AD.
This study included an exposure-matched cohort of all Finnish community-dwelling women who received a clinically verified diagnosis of AD in 2005-2011 (N?=?46,116; index cases) and an equally sized matched comparison cohort without AD. Follow-up began on the matching date (date of the AD diagnosis of the index case). Data on systemic estrogen use were obtained from the prescription register. Use initiation and discontinuation were assessed.
Altogether 3.1% of women with AD and 4.3% of women without AD used estrogen during the follow-up period. Only?
PubMed ID
30317535 View in PubMed
Less detail

Use of antidepressants among community-dwelling persons with Alzheimer's disease: a nationwide register-based study.

https://arctichealth.org/en/permalink/ahliterature268450
Source
Int Psychogeriatr. 2015 Apr;27(4):669-72
Publication Type
Article
Date
Apr-2015
Author
Marja-Liisa Laitinen
Eija Lönnroos
J Simon Bell
Piia Lavikainen
Raimo Sulkava
Sirpa Hartikainen
Source
Int Psychogeriatr. 2015 Apr;27(4):669-72
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Alzheimer Disease - complications - drug therapy - psychology
Antidepressive Agents - therapeutic use
Case-Control Studies
Depression - drug therapy - etiology
Female
Finland - epidemiology
Humans
Independent Living - psychology - statistics & numerical data
Male
Middle Aged
Practice Patterns, Physicians' - statistics & numerical data
Registries
Sex Factors
Abstract
Antidepressants are used to treat depression and behavioral symptoms in Alzheimer's disease (AD), although their effectiveness has been questioned and evidence about the risks is accumulating. The objective of this study was to compare antidepressant use among persons with and without AD in Finland.
The Social Insurance Institution of Finland (SII) identified all persons with a verified diagnosis of AD in Finland on December 31, 2005. For each person with AD a comparison person matched for age, sex and region of residence was also identified. Data on reimbursed drug purchases in 2005 were extracted from the Finnish National Prescription Register (FNPR). Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for antidepressant use.
The study sample comprised of 28,089 matched pairs of persons with and without AD (mean age 80.0 SD 6.8, 32.2% men).The prevalence of antidepressant use was higher among persons with AD than without AD (29.4% vs. 10.7%, OR = 3.54; 95% CI: 3.38, 3.70). Among the persons with AD, the prevalence of antidepressant use increased with time since AD diagnosis but not with age. Overall, 90.4% of antidepressant users with AD were co-dispensed anti-dementia drugs.
The antidepressant use was three times more prevalent among persons with AD compared to those without. Though the antidepressant selection was largely consistent with clinical practice guidelines, the high prevalence of use warrants further investigation given the uncertain effectiveness and adverse events related to these drugs.
PubMed ID
25412711 View in PubMed
Less detail

9 records – page 1 of 1.