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

Published online by Cambridge University Press:  21 November 2014

Marja-Liisa Laitinen ,
Eija Lönnroos ,
J. Simon Bell ,
Piia Lavikainen ,
Raimo Sulkava  and
Sirpa Hartikainen
Marja-Liisa Laitinen*
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland Institute of Public Health and Clinical Nutrition, Department of Geriatrics, University of Eastern Finland, Kuopio, Finland
Eija Lönnroos
Affiliation:
Institute of Public Health and Clinical Nutrition, Department of Geriatrics, University of Eastern Finland, Kuopio, Finland
J. Simon Bell
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland Institute of Public Health and Clinical Nutrition, Department of Geriatrics, University of Eastern Finland, Kuopio, Finland Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute, University of South Australia, Adelaide, Australia Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
Piia Lavikainen
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
Raimo Sulkava
Affiliation:
Institute of Public Health and Clinical Nutrition, Department of Geriatrics, University of Eastern Finland, Kuopio, Finland
Sirpa Hartikainen
Affiliation:
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
*
Correspondence should be addressed to: Marja-Liisa Laitinen, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland. Phone: +358445361308. Email: marja-liisa.laitinen@uef.fi.
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Abstract

Background:

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.

Methods:

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.

Results:

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.

Conclusions:

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.

Keywords

Alzheimer diseaseantidepressive agents
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 4 , April 2015 , pp. 669 - 672
Copyright
Copyright © International Psychogeriatric Association 2014 

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