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Prevalence and correlates of psychotropic drug use in community-dwelling people with young-onset dementia: the NeedYD-study

Published online by Cambridge University Press:  10 January 2014

Raymond T.C.M. Koopmans ,
Renate Reinders ,
Deliane van Vliet ,
Frans R.J. Verhey ,
Marjolein E. de Vugt ,
Hans Bor  and
Christian Bakker
Raymond T.C.M. Koopmans*
Affiliation:
Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands
Renate Reinders
Affiliation:
Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands
Deliane van Vliet
Affiliation:
Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands
Frans R.J. Verhey
Affiliation:
School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands
Marjolein E. de Vugt
Affiliation:
School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands
Hans Bor
Affiliation:
Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands
Christian Bakker
Affiliation:
Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands Florence, Mariahoeve, Centre for Specialized Care in Early Onset Dementia, The Hague, the Netherlands
*
Correspondence should be addressed to: Prof. (Dr.) R.T.C.M. Koopmans, Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, P.O. Box 9101, 117 ELG, 6500 HB Nijmegen. Phone: +31-24-3655307; Fax: +31-24-3541862. Email: [email protected].
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Abstract

Background:

Young-onset dementia (YOD) is defined as dementia that develops before the age of 65 years. The prevalence and type of neuropsychiatric symptoms (NPS) in YOD differ from patients with late onset dementia. NPS in dementia patients are often treated with psychotropic drugs. The aim of this study was to investigate psychotropic drug use (PDU) in Dutch community-dwelling YOD patients and the association between age, gender, dementia etiology and severity, symptoms of depression, disease awareness, unmet needs, and type of NPS.

Methods:

Psychotropic drug use in 196 YOD patients was registered. Drugs were categorized according to the Anatomical Therapeutical Chemical classification. The association between age, gender, dementia type, dementia stage, type of NPS, depressive symptoms, disease awareness, and amount of unmet needs on total PDU was analyzed using binomial logistic regression analysis.

Results:

Fifty-two percent of the patients were prescribed at least one psychotropic drug; 36.2% of patients used one drug, and 12.2% used two different drugs. Antidepressants (36.2%) and antipsychotic drugs (17.3%) were the most frequently prescribed psychotropic drugs. Anti-dementia drugs were prescribed in 51.5% of the patients. Increasing age and moderate to severe depressive symptoms were positively associated with the total use of psychotropic drugs.

Conclusions:

Community-dwelling YOD patients have a high prevalence of PDU. More research is needed to study the association between unmet needs, NPS, and PDU, and psychosocial interventions have to be developed to limit the use of psychotropic drugs in YOD.

Keywords

young-onset dementianeuropsychiatric symptomscommunity-dwellingpsychotropic drug useantipsychoticsantidepressantsanxiolyticshypnotics
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Special Issue 12: young onset dementia , December 2014 , pp. 1983 - 1989
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23, 271–284.CrossRefGoogle ScholarPubMed
Bakker, C. et al. (2013). The use of formal and informal care in early onset dementia: results from the NeedYD study. American Journal of Geriatric Psychiatry, 21, 37–45.CrossRefGoogle ScholarPubMed
Bakker, C. et al. (2013). The relationship between unmet care needs in young-onset dementia and the course of neuropsychiatric symptoms: a two-year follow-up study. International Psychogeriatrics. doi: http://dx.doi.org/10.1017/S1041610213001476.CrossRefGoogle Scholar
Ballard, C. and Howard, R. (2006). Neuroleptic drugs in dementia: benefits and harm. Nature Reviews. Neuroscience, 7, 492–500.CrossRefGoogle ScholarPubMed
Barca, M. L., Engedal, K. and Selbaek, G. (2010). A reliability and validity study of the Cornell scale among elderly inpatients, using various clinical criteria. Dementia and Geriatric Cognitive Disorders, 29, 438–447.CrossRefGoogle ScholarPubMed
Chan, D. C., Kasper, J. D., Black, B. S. and Rabins, P. V. (2007). Clinical diagnosis of dementia, not behavioral and psychologic symptoms, is associated with psychotropic drug use in community-dwelling elders classified as having dementia. Journal of Geriatric Psychiatry and Neurology, 20, 100–106.CrossRefGoogle Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Donders, A. R., van der Heijden, G. J., Stijnen, T. and Moons, K. G. (2006). Review: a gentle introduction to imputation of missing values. Journal of Clinical Epidemiology, 59, 1087–1091.CrossRefGoogle ScholarPubMed
Harvey, R. J., Skelton-Robinson, M. and Rossor, M. N. (2003). The prevalence and causes of dementia in people under the age of 65 years. Journal of Neurology, Neurosurgery, and Psychiatry, 74, 1206–1209.CrossRefGoogle ScholarPubMed
Ikejima, C., Yasuno, F., Mizukami, K., Sasaki, M., Tanimukai, S. and Asada, T. (2009). Prevalence and causes of early-onset dementia in Japan: a population-based study. Stroke, 40, 2709–2714.CrossRefGoogle ScholarPubMed
Kat, M. G., de Jonghe, J. F. M., Aalten, P., Kalisvaart, C. J., Droes, R. M., Verhey, F. R. J. (2002). Neuropsychiatrische symptomen bij dementie: psychometrische aspecten van de Nederlandse Neuropsychiatric Inventory (NPI). Tijdschrift voor Gerontologie en Geriatrie, 33, 150–155.Google Scholar
Kim, H. and Whall, A. L. (2006). Factors associated with psychotropic drug usage among nursing home residents with dementia. Nursing Research, 55, 252–258.CrossRefGoogle ScholarPubMed
Lebert, F., Stekke, W., Hasenbroekx, C. and Pasquier, F. (2004). Frontotemporal dementia: a randomised, controlled trial with trazodone. Dementia and Geriatric Cognitive Disorders, 17, 355–359.CrossRefGoogle ScholarPubMed
Leontjevas, R., van Hooren, S. and Mulders, A. (2009). The Montgomery-Asberg Depression Rating Scale and the Cornell Scale for Depression in Dementia: a validation study with patients exhibiting early-onset dementia. American Journal of Geriatric Psychiatry, 17, 56–64.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Steinberg, M., Tschanz, J. T., Norton, M. C., Steffens, D. C. and Breitner, J. C. (2000). Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. The American Journal of Psychiatry, 157, 708–714.CrossRefGoogle Scholar
Miyoshi, K. (2009). What is “early onset dementia”? Psychogeriatrics, 9, 67–72.CrossRefGoogle Scholar
Nijk, R. M., Zuidema, S. U. and Koopmans, R. T. (2009). Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia. International Psychogeriatrics, 21, 485–493.CrossRefGoogle ScholarPubMed
Nordic Council on Medicines. (1990). Guideline for ATC Classification. Unpublished manuscript. Oslo, Norway: WHO Collaborating Center for Drugs Statistics Methodology.Google Scholar
Orrell, M., Cooper, C. and Braithwaite, S. (2006). Do carers’ needs assessments make a difference? Results from the Forget Me Not study. Age and Ageing, 35, 444–445.CrossRefGoogle ScholarPubMed
Picard, C., Pasquier, F., Martinaud, O., Hannequin, D. and Godefroy, O. (2011). Early onset dementia: characteristics in a large cohort from academic memory clinics. Alzheimer Disease and Associated Disorders, 25, 203–205.CrossRefGoogle Scholar
Reisberg, B., Ferris, S. H., de Leon, M. J. and Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, 1136–1139.Google ScholarPubMed
Reynolds, T. et al. (2000). Camberwell Assessment of Need for the Elderly (CANE). Development, validity and reliability. British Journal of Psychiatry, 176, 444–452.CrossRefGoogle ScholarPubMed
Richter, T., Meyer, G., Mohler, R. and Kopke, S. (2012). Psychosocial interventions for reducing antipsychotic medication in care home residents. Cochrane Database of Systematic Reviews, 12, CD008634.Google ScholarPubMed
Rosness, T. A., Barca, M. L. and Engedal, K. (2010). Occurrence of depression and its correlates in early onset dementia patients. International Journal of Geriatric Psychiatry, 25, 704–711.CrossRefGoogle ScholarPubMed
Selbaek, G., Kirkevold, O. and Engedal, K. (2007). The prevalence of psychiatric symptoms and behavioural disturbances and the use of psychotropic drugs in Norwegian nursing homes. International Journal of Geriatric Psychiatry, 22, 843–849.CrossRefGoogle ScholarPubMed
Selbaek, G., Kirkevold, O. and Engedal, K. (2008). Psychiatric and behavioural symptoms and the use of psychotropic medication in special care units and regular units in Norwegian nursing homes. Scandinavian Journal of Caring Sciences, 22, 568–573.CrossRefGoogle ScholarPubMed
Semla, T. P. et al. (1995). Psychotropic drug use in relation to psychiatric symptoms in community-living persons with Alzheimer's disease. Pharmacotherapy, 15, 495–501.CrossRefGoogle ScholarPubMed
Toyota, Y. et al. (2007). Comparison of behavioral and psychological symptoms in early-onset and late-onset Alzheimer's disease. International Journal of Geriatric Psychiatry, 22, 896–901.CrossRefGoogle ScholarPubMed
van Vliet, D., Bakker, C., Koopmans, R. T., Vernooij-Dassen, M. J., Verhey, F. R. and de Vugt, M. E. (2010). Research protocol of the NeedYD-study (Needs in Young onset Dementia): a prospective cohort study on the needs and course of early onset dementia. BMC Geriatrics, 10, 13.CrossRefGoogle ScholarPubMed
van Vliet, D. et al. (2012). Prevalence of neuropsychiatric symptoms in young-onset compared to late-onset Alzheimer's disease – part 1: findings of the two-year longitudinal NeedYD-study. Dementia and Geriatric Cognitive Disorders, 34, 319–327.CrossRefGoogle ScholarPubMed
van Vliet, D. et al. (2013). Awareness and its association with affective symptoms in young-onset and late-onset Alzheimer disease: a prospective study. Alzheimer's Disease and Associated Disorders, 27, 265–271.CrossRefGoogle ScholarPubMed
Verhey, F. R., Rozendaal, N., Ponds, R. W. and Jolles, J. (1993). Dementia, awareness and depression. International Journal of Psychiatry, 8, 851–856.Google Scholar