Abstract
Aims: Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer’s disease (AD) living in the US and Finland. Methods: We used data collected between 2005 and 2011 as part of the National Alzheimer’s Coordinating Center (NACC) in the US, and Medication use and Alzheimer’s disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable logistic regression adjusted for demographics, co-morbidities, and other medications to estimate the magnitude of the association (adjusted odds ratio [aOR] with 95% confidence intervals [CIs]) according to sex. Results: We included 1099 NACC participants (502 [45.68%] men, 597 [54.32%] women), and 67,049 participants from the MEDALZ cohort (22,961 [34.24%] men, 44,088 [65.75%] women). Women were more likely than men to use psychotropic medications: US, 46.2% vs. 33.1%, p < 0.001; Finland, 45.3% vs. 36.1%, p < 0.001; aOR was 2.06 (95% CI 1.58–2.70) in the US cohort and 1.38 (95% CI 1.33–1.43) in the Finnish cohort. Similarly, of the different psychotropic medications, women were more likely to use antidepressants (aOR-US: 2.16 [1.44–3.25], Finland: 1.52 [1.45–1.58]) and anxiolytics (aOR-US: 2.16 [1.83–3.96], Finland: 1.17 [1.13-1.23]) than men. Conclusion: Older women with AD are more likely to use psychotropic medications than older men, regardless of study population and country. Approaches to mitigate psychotropic medication use need to consider different prescribing habits observed in older women vs. men with AD.
| Original language | English |
|---|---|
| Pages (from-to) | 55-65 |
| Number of pages | 11 |
| Journal | Drugs and Aging |
| Volume | 34 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2017 |
Bibliographical note
Publisher Copyright:© 2016, Springer International Publishing Switzerland.
Funding
This work was supported by Grant No. K12 DA035150 (Building Interdisciplinary Research Careers in Women's Health) from the National Institutes of Health, Office of Women's Health Research and the National Institute on Drug Abuse (DM) and National Health and Medical Research Early Career Fellowship (DG). The NACC database is funded by the National Institute on Aging (NIA)/National Institutes of Health (NIH) Grant U01 AG016976. NACC data are contributed to by the NIA-funded ADCs: P30 AG019610 (PI Eric Reiman, MD), P30 AG013846 (PI Neil Kowall, MD), P50 AG008702 (PI Scott Small, MD), P50 AG025688 (PI Allan Levey, MD, PhD), P50 AG047266 (PI Todd Golde, MD, PhD), P30 AG010133 (PI Andrew Saykin, PsyD), P50 AG005146 (PI Marilyn Albert, PhD), P50 AG005134 (PI Bradley Hyman, MD, PhD), P50 AG016574 (PI Ronald Petersen, MD, PhD), P50 AG005138 (PI Mary Sano, PhD), P30 AG008051 (PI Steven Ferris, PhD), P30 AG013854 (PI M. Marsel Mesulam, MD), P30 AG008017 (PI Jeffrey Kaye, MD), P30 AG010161 (PI David Bennett, MD), P50 AG047366 (PI Victor Henderson, MD, MS), P30 AG010129 (PI Charles DeCarli, MD), P50 AG016573 (PI Frank LaFerla, PhD), P50 AG016570 (PI Marie-Francoise Chesselet, MD, PhD), P50 AG005131 (PI Douglas Galasko, MD), P50 AG023501 (PI Bruce Miller, MD), P30 AG035982 (PI Russell Swerdlow, MD), P30 AG028383 (PI Linda Van Eldik, PhD), P30 AG010124 (PI John Trojanowski, MD, PhD), P50 AG005133 (PI Oscar Lopez, MD), P50 AG005142 (PI Helena Chui, MD), P30 AG012300 (PI Roger Rosenberg, MD), P50 AG005136 (PI Thomas Montine, MD, PhD), P50 AG033514 (PI Sanjay Asthana, MD, FRCP), P50 AG005681 (PI John Morris, MD), and P50 AG047270 (PI Stephen Strittmatter, MD, PhD).
| Funders | Funder number |
|---|---|
| Australian National Health and Medical Research Centre | |
| National Institutes of Health (NIH) | P30 AG013846, P30 AG028383, P30 AG008017, P30 AG010133, P50 AG005146, P50 AG033514, P50 AG005142, P50 AG005681, P50 AG047366, P50 AG047266, P30 AG019610, P50 AG023501, P30 AG008051, P30 AG010129, P30 AG013854, P50 AG005138, P50 AG008702, P30 AG010124, P30 AG012300, P50 AG005134, P50 AG005136, P50 AG047270, U01 AG016976, P30 AG035982, P30 AG010161, P50 AG005131, P50 AG005133, P50 AG016574, P50 AG016573, P50 AG016570 |
| National Institutes of Health (NIH) | |
| National Institute on Drug Abuse | |
| National Institute on Aging | P50AG025688 |
| National Institute on Aging | |
| Office of Research on Women's Health |
ASJC Scopus subject areas
- Geriatrics and Gerontology
- Pharmacology (medical)