Skip to main content
Top
Published in: BMC Geriatrics 1/2015

Open Access 01-12-2015 | Research article

Social differences associated with the use of psychotropic drugs among men and women aged 65 to 74 years living in the community: the international mobility in aging study (IMIAS)

Authors: Gustave Noufou Nana, Boukaré Doulougou, Fernando Gomez, Alban Ylli, Jack Guralnik, Maria Victoria Zunzunegui

Published in: BMC Geriatrics | Issue 1/2015

Login to get access

Abstract

Background

Elderly persons make greater use of psychotropic drugs, but there are few international studies on social differences in the use of these medications. The aim of this study is to examine social differences in the use of psychotropic drugs among persons aged 65–74 years in the International Mobility in Aging Study (IMIAS).

Methods

The sample consisted of 1,995 participants in the IMIAS 2012 baseline study in Saint-Hyacinthe (Canada), Kingston (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). During home visits, all medication taken by the participants in the previous 15 days was recorded. We then used the Anatomical Therapeutic Chemical classification system to code psychotropic drugs as anxiolytics, sedatives, hypnotics (ASH); antidepressants (ADP); or analgesics, antiepileptics, or antiparkinsonians (AEP). Prevalence ratios for psychotropic drug use according to sex, education, income, and occupation were estimated by fitting a Poisson regression and controlling for demographic and health covariates.

Results

Psychotropic drug use was higher among Canadian participants than among those living outside Canada. Prevalence of AEP drug use was higher for women than men in the Canadian and Latin American sites. In Tirana, antidepressant drugs were rarely used. Socioeconomic differences varied among sites. In the Canadian cities, low socioeconomic standing was associated with higher frequency of psychotropic drug use. In the Latin American cities, elderly people with high education and income levels showed a higher level of antidepressant drug use, while people with manual occupations had a higher use of AEP drugs. In Tirana, ASH drug use was higher among those with low income.

Conclusion

An inverse association was observed between socioeconomic standing and psychotropic drug use in Canada, while the opposite was true in Latin America. Albania was notable for an absence of antidepressant use and greater use of ASH drugs among low-income groups.
Literature
1.
go back to reference Blumstein T, Benyamini Y, Chetrit A, Mizrahi EH, Lerner-Geva L. Prevalence and correlates of psychotropic medication use among older adults in Israel: cross-sectional and longitudinal findings from two cohorts a decade apart. Aging Ment Health. 2012;16(5):636–47.CrossRefPubMedPubMedCentral Blumstein T, Benyamini Y, Chetrit A, Mizrahi EH, Lerner-Geva L. Prevalence and correlates of psychotropic medication use among older adults in Israel: cross-sectional and longitudinal findings from two cohorts a decade apart. Aging Ment Health. 2012;16(5):636–47.CrossRefPubMedPubMedCentral
2.
go back to reference Zhang Y, Chow V, Vitry AI, Ryan P, Roughead EE, Caughey GE, et al. Antidepressant use and depressive symptomatology among older people from the Australian longitudinal Study of Ageing. Int Psychogeriatr. 2010;22(2):437–44.CrossRefPubMed Zhang Y, Chow V, Vitry AI, Ryan P, Roughead EE, Caughey GE, et al. Antidepressant use and depressive symptomatology among older people from the Australian longitudinal Study of Ageing. Int Psychogeriatr. 2010;22(2):437–44.CrossRefPubMed
3.
go back to reference Mojtabai R, Olfson M. Proportion of antidepressants prescribed without a psychiatric diagnosis is growing. Health Aff (Millwood). 2011;30(8):1434–42.CrossRef Mojtabai R, Olfson M. Proportion of antidepressants prescribed without a psychiatric diagnosis is growing. Health Aff (Millwood). 2011;30(8):1434–42.CrossRef
4.
go back to reference Noordam R, Aarts N, Verhamme KM, Sturkenboom MC, Stricker BH, Visser LE. Prescription and indication trends of antidepressant drugs in the Netherlands between 1996 and 2012: a dynamic population-based study. Eur J Clin Pharmacol. 2015;71(3):369–75.CrossRefPubMed Noordam R, Aarts N, Verhamme KM, Sturkenboom MC, Stricker BH, Visser LE. Prescription and indication trends of antidepressant drugs in the Netherlands between 1996 and 2012: a dynamic population-based study. Eur J Clin Pharmacol. 2015;71(3):369–75.CrossRefPubMed
5.
go back to reference Lader M. Long-term anxiolytic therapy: the issue of drug withdrawal. J Clin Psychiatry. 1987;48(Suppl):12–6.PubMed Lader M. Long-term anxiolytic therapy: the issue of drug withdrawal. J Clin Psychiatry. 1987;48(Suppl):12–6.PubMed
6.
go back to reference Lai HY, Hwang SJ, Chen YC, Chen TJ, Lin MH, Chen LK. Prevalence of the prescribing of potentially inappropriate medications at ambulatory care visits by elderly patients covered by the Taiwanese National Health Insurance program. Clin Ther. 2009;31(8):1859–70.CrossRefPubMed Lai HY, Hwang SJ, Chen YC, Chen TJ, Lin MH, Chen LK. Prevalence of the prescribing of potentially inappropriate medications at ambulatory care visits by elderly patients covered by the Taiwanese National Health Insurance program. Clin Ther. 2009;31(8):1859–70.CrossRefPubMed
7.
go back to reference Akazawa M, Imai H, Igarashi A, Tsutani K. Potentially inappropriate medication use in elderly Japanese patients. Am J Geriatr Pharmacother. 2010;8(2):146–60.CrossRefPubMed Akazawa M, Imai H, Igarashi A, Tsutani K. Potentially inappropriate medication use in elderly Japanese patients. Am J Geriatr Pharmacother. 2010;8(2):146–60.CrossRefPubMed
8.
go back to reference Ambresin G, Palmer V, Densley K, Dowrick C, Gilchrist G, Gunn JM. What factors influence long-term antidepressant use in primary care? Findings from the Australian diamond cohort study. J Affect Disord. 2015;176:125–32.CrossRefPubMed Ambresin G, Palmer V, Densley K, Dowrick C, Gilchrist G, Gunn JM. What factors influence long-term antidepressant use in primary care? Findings from the Australian diamond cohort study. J Affect Disord. 2015;176:125–32.CrossRefPubMed
9.
go back to reference Allard J, Allaire D, Leclerc G, Langlois SP. The influence of family and social relationships on the consumption of psychotropic drugs by the elderly. Arch Gerontol Geriatr. 1995;20(2):193–204.CrossRefPubMed Allard J, Allaire D, Leclerc G, Langlois SP. The influence of family and social relationships on the consumption of psychotropic drugs by the elderly. Arch Gerontol Geriatr. 1995;20(2):193–204.CrossRefPubMed
10.
go back to reference Bossé C. Caracterisation de la consommation d'antidepresseurs chez les personnes âgées vivant à domicile. In: Université de Sherbrook. Sherbrook: Université de Sherbrook; 2012. Bossé C. Caracterisation de la consommation d'antidepresseurs chez les personnes âgées vivant à domicile. In: Université de Sherbrook. Sherbrook: Université de Sherbrook; 2012.
11.
go back to reference Dealberto MJ, Seeman T, McAvay GJ, Berkman L. Factors related to current and subsequent psychotropic drug use in an elderly cohort. J Clin Epidemiol. 1997;50(3):357–64.CrossRefPubMed Dealberto MJ, Seeman T, McAvay GJ, Berkman L. Factors related to current and subsequent psychotropic drug use in an elderly cohort. J Clin Epidemiol. 1997;50(3):357–64.CrossRefPubMed
12.
go back to reference Rubio-Valera M, Fernandez A, Luciano JV, Hughes CM, Pinto-Meza A, Moreno-Kustner B, et al. Psychotropic prescribing in Catalonia: results from an epidemiological study. Fam Pract. 2012;29(2):154–62.CrossRefPubMed Rubio-Valera M, Fernandez A, Luciano JV, Hughes CM, Pinto-Meza A, Moreno-Kustner B, et al. Psychotropic prescribing in Catalonia: results from an epidemiological study. Fam Pract. 2012;29(2):154–62.CrossRefPubMed
13.
go back to reference Gustafsson T, Isacson D, Thorslund M, Sorbom D. Factors associated with psychotropic drug use among the elderly living at home. J Applied Gerontol. 1996;15(2):238–54.CrossRef Gustafsson T, Isacson D, Thorslund M, Sorbom D. Factors associated with psychotropic drug use among the elderly living at home. J Applied Gerontol. 1996;15(2):238–54.CrossRef
14.
go back to reference Wastesson JW, Fastbom J, Ringback Weitoft G, Fors S, Johnell K. Socioeconomic inequalities in access to specialized psychotropic prescribing among older Swedes: a register-based study. Eur J Public Health. 2014;24(6):991–6.CrossRefPubMed Wastesson JW, Fastbom J, Ringback Weitoft G, Fors S, Johnell K. Socioeconomic inequalities in access to specialized psychotropic prescribing among older Swedes: a register-based study. Eur J Public Health. 2014;24(6):991–6.CrossRefPubMed
15.
go back to reference Paige E, Korda RJ, Kemp A, Rodgers B, Banks E. Characteristics of antidepressant medication users in a cohort of mid-age and older Australians. Aust N Z J Psychiatry. 2015;49(3):275–90.CrossRefPubMed Paige E, Korda RJ, Kemp A, Rodgers B, Banks E. Characteristics of antidepressant medication users in a cohort of mid-age and older Australians. Aust N Z J Psychiatry. 2015;49(3):275–90.CrossRefPubMed
16.
go back to reference Sousa AC, Guerra RO, Thanh Tu M, Phillips SP, Guralnik JM, Zunzunegui MV. Lifecourse adversity and physical performance across countries among men and women aged 65–74. PLoS One. 2014;9(8), e102299.CrossRefPubMedPubMedCentral Sousa AC, Guerra RO, Thanh Tu M, Phillips SP, Guralnik JM, Zunzunegui MV. Lifecourse adversity and physical performance across countries among men and women aged 65–74. PLoS One. 2014;9(8), e102299.CrossRefPubMedPubMedCentral
17.
go back to reference De Yebenes JG, Sanchez M, Mena MA. Neurotrophic factors for the investigation and treatment of movement disorders. Neurotox Res. 2003;5(1–2):119–38.CrossRefPubMed De Yebenes JG, Sanchez M, Mena MA. Neurotrophic factors for the investigation and treatment of movement disorders. Neurotox Res. 2003;5(1–2):119–38.CrossRefPubMed
21.
go back to reference Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef
22.
go back to reference Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.CrossRefPubMedPubMedCentral Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.CrossRefPubMedPubMedCentral
23.
go back to reference Petrea I, Haggenburg M. Chapter 10: Mental health care. In: Rechel B, Richardson E, McKee M, editors. Trends in health systems in the former Soviet countries. Copenhagen: WHO; 2014. p. 159–72. Petrea I, Haggenburg M. Chapter 10: Mental health care. In: Rechel B, Richardson E, McKee M, editors. Trends in health systems in the former Soviet countries. Copenhagen: WHO; 2014. p. 159–72.
24.
go back to reference Petrea I. Mental health in former Soviet countries: From past legacies to modern practices. Public Health Rev. 2013;34:2. Petrea I. Mental health in former Soviet countries: From past legacies to modern practices. Public Health Rev. 2013;34:2.
26.
go back to reference Kakariqi L. Konsumi i barnave te rimbursueshem ne Shqiperi. Tirana: Marin Barleti; 2014. Kakariqi L. Konsumi i barnave te rimbursueshem ne Shqiperi. Tirana: Marin Barleti; 2014.
27.
go back to reference Richardson E, Sautenkova N, Bolokhovets G. Chapter 9: Pharmaceutical care. In: Rechel B, Richardson E, McKee M, editors. Trends in health systems in the former Soviet countries. Copenhagen: WHO; 2014. p. 145–58. Richardson E, Sautenkova N, Bolokhovets G. Chapter 9: Pharmaceutical care. In: Rechel B, Richardson E, McKee M, editors. Trends in health systems in the former Soviet countries. Copenhagen: WHO; 2014. p. 145–58.
28.
go back to reference Alvarenga JM, Loyola Filho AI, Firmo JO, Lima-Costa MF, Uchoa E. Prevalence and sociodemographic characteristics associated with benzodiazepines use among community dwelling older adults: the Bambui Health and Aging Study (BHAS). Rev Bras Psiquiatr. 2008;30(1):7–11.CrossRefPubMed Alvarenga JM, Loyola Filho AI, Firmo JO, Lima-Costa MF, Uchoa E. Prevalence and sociodemographic characteristics associated with benzodiazepines use among community dwelling older adults: the Bambui Health and Aging Study (BHAS). Rev Bras Psiquiatr. 2008;30(1):7–11.CrossRefPubMed
29.
go back to reference Bierman AS, Pugh MJ, Dhalla I, Amuan M, Fincke BG, Rosen A, et al. Sex differences in inappropriate prescribing among elderly veterans. Am J Geriatr Pharmacother. 2007;5(2):147–61.CrossRefPubMed Bierman AS, Pugh MJ, Dhalla I, Amuan M, Fincke BG, Rosen A, et al. Sex differences in inappropriate prescribing among elderly veterans. Am J Geriatr Pharmacother. 2007;5(2):147–61.CrossRefPubMed
30.
go back to reference Huang B, Bachmann KA, He X, Chen R, McAllister JS, Wang T. Inappropriate prescriptions for the aging population of the United States: an analysis of the national ambulatory medical care survey, 1997. Pharmacoepidemiol Drug Saf. 2002;11(2):127–34.CrossRefPubMed Huang B, Bachmann KA, He X, Chen R, McAllister JS, Wang T. Inappropriate prescriptions for the aging population of the United States: an analysis of the national ambulatory medical care survey, 1997. Pharmacoepidemiol Drug Saf. 2002;11(2):127–34.CrossRefPubMed
31.
go back to reference Blumstein T, Benyamini Y, Shmotkin D, Lerner-Geva L. Gender differences in the prevalence and correlates of psychotropic medication use among older adults in Israel. Isr J Psychiatry Relat Sci. 2014;51(2):118–25.PubMed Blumstein T, Benyamini Y, Shmotkin D, Lerner-Geva L. Gender differences in the prevalence and correlates of psychotropic medication use among older adults in Israel. Isr J Psychiatry Relat Sci. 2014;51(2):118–25.PubMed
32.
go back to reference Hohmann AA. Gender bias in psychotropic drug prescribing in primary care. Med Care. 1989;27(5):478–90.CrossRefPubMed Hohmann AA. Gender bias in psychotropic drug prescribing in primary care. Med Care. 1989;27(5):478–90.CrossRefPubMed
33.
go back to reference Lane CJ, Bronskill SE, Sykora K, Dhalla IA, Anderson GM, Mamdani MM, et al. Potentially inappropriate prescribing in Ontario community-dwelling older adults and nursing home residents. J Am Geriatr Soc. 2004;52(6):861–6.CrossRefPubMed Lane CJ, Bronskill SE, Sykora K, Dhalla IA, Anderson GM, Mamdani MM, et al. Potentially inappropriate prescribing in Ontario community-dwelling older adults and nursing home residents. J Am Geriatr Soc. 2004;52(6):861–6.CrossRefPubMed
34.
go back to reference Swami V. Mental health literacy of depression: gender differences and attitudinal antecedents in a representative British sample. PLoS One. 2012;7(11), e49779.CrossRefPubMedPubMedCentral Swami V. Mental health literacy of depression: gender differences and attitudinal antecedents in a representative British sample. PLoS One. 2012;7(11), e49779.CrossRefPubMedPubMedCentral
35.
36.
go back to reference Addis ME, Mahalik JR. Men, masculinity, and the contexts of help seeking. Am Psychol. 2003;58(1):5–14.CrossRefPubMed Addis ME, Mahalik JR. Men, masculinity, and the contexts of help seeking. Am Psychol. 2003;58(1):5–14.CrossRefPubMed
37.
go back to reference Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour: literature review. J Adv Nurs. 2005;49(6):616–23.CrossRefPubMed Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour: literature review. J Adv Nurs. 2005;49(6):616–23.CrossRefPubMed
38.
go back to reference McVittie C, Willock J. "You can't fight windmills": how older men do health, ill health, and masculinities. Qual. Health Res. 2006;16(6):788–801. McVittie C, Willock J. "You can't fight windmills": how older men do health, ill health, and masculinities. Qual. Health Res. 2006;16(6):788–801.
39.
go back to reference Alvarenga JM, Loyola Filho AI, Firmo JO, Lima-Costa MF, Uchoa E. A population based study on health conditions associated with the use of benzodiazepines among older adults (The Bambui Health and Aging Study). Cad Saude Publica. 2009;25(3):605–12.CrossRefPubMed Alvarenga JM, Loyola Filho AI, Firmo JO, Lima-Costa MF, Uchoa E. A population based study on health conditions associated with the use of benzodiazepines among older adults (The Bambui Health and Aging Study). Cad Saude Publica. 2009;25(3):605–12.CrossRefPubMed
40.
go back to reference Lynch JW, Kaplan GA. Socioeconomic factors. In: Berkman LF, Kavachi I, editors. Social Epidemiology. New York: Oxford University Press; 2000. p. 13–35. Lynch JW, Kaplan GA. Socioeconomic factors. In: Berkman LF, Kavachi I, editors. Social Epidemiology. New York: Oxford University Press; 2000. p. 13–35.
41.
go back to reference Grundy E, Holt G. The socioeconomic status of older adults: how should we measure it in studies of health inequalities? J Epidemiol Community Health. 2001;55(12):895–904.CrossRefPubMedPubMedCentral Grundy E, Holt G. The socioeconomic status of older adults: how should we measure it in studies of health inequalities? J Epidemiol Community Health. 2001;55(12):895–904.CrossRefPubMedPubMedCentral
Metadata
Title
Social differences associated with the use of psychotropic drugs among men and women aged 65 to 74 years living in the community: the international mobility in aging study (IMIAS)
Authors
Gustave Noufou Nana
Boukaré Doulougou
Fernando Gomez
Alban Ylli
Jack Guralnik
Maria Victoria Zunzunegui
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2015
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-015-0083-3

Other articles of this Issue 1/2015

BMC Geriatrics 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.