International Psychogeriatrics

Research Article

Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia

Renate M. Nijka1a2 c1, Sytse U. Zuidemaa1 and Raymond T. C. M. Koopmansa1

a1 Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, Nijmegen, The Netherlands

a2 van Neynselgroep, 's Hertogenbosch, The Netherlands

ABSTRACT

Background: Neuropsychiatric symptoms in dementia patients are common and are often treated with psychotropic drugs. The aim of this study was to determine the prevalence and correlates of psychotropic drug use in Dutch nursing home patients with dementia.

Methods: Psychotropic drug use of 1322 patients on 59 dementia special care units (SCUs) in 25 nursing homes was registered. Drugs were categorized according to the Anatomical Therapeutical Chemical classification (ATC). The influence of age, gender, dementia stage measured by the Global Deterioration Scale (GDS), and type of neuropsychiatric symptoms on psychotropic drug use was analyzed using binomial logistic regression analysis.

Results: 63% of the patients used at least one psychotropic drug. Psychotropics in general and antipsychotics in particular were most frequently prescribed in GDS stage 6, and in patients aged between 65 and 75 years. Psychotropics in general were positively associated with depression, night-time behavior and agitation. Antipsychotic drug use was positively associated with psychosis, agitation and night-time behavior and was negatively associated with apathy. Anxiolytics were associated with age, psychosis, agitation and night-time behavior. Antidepressants were most frequently prescribed in GDS stage 6 and associated with female gender, agitation and depression. Sedatives were only associated with night-time behavior.

Conclusion: Nursing home patients with dementia have a high prevalence of psychotropic drug use. In particular, the association with neuropsychiatric symptoms raises questions of efficacy of these drugs and the risk of chronic use.

(Received September 17 2008)

(Revised October 29 2008)

(Revised January 20 2009)

(Accepted January 21 2009)

(Online publication April 16 2009)

Correspondence:

c1 Correspondence should be addressed to: R. M. Nijk, van Neynselgroep, P.O Box 90112, 5200 MA, 's Hertogenbosch, The Netherlands. Phone: +31 (0)73 658 3000, Fax: +31 (0)73 680 3060. Email: r.nijk@vanneynsel.nl.