DRUG-USE BY DEMENTED AND NONDEMENTED ELDERLY PEOPLE

Aim: to determine the use of drugs by demented and non-demented elderl y people in a population, by dementia status and type, age, sex and ac commodation type. Method: data were obtained from the Kungsholmen proj ect, a longitudinal community study of people over 75 in Stockholm, Sw eden. Results: 85% used at least one medicinal drug, and of these 12% were demented. Mean numbers of drugs used were 2.8 for demented and 3. 2 for non-demented people. 45% of demented people and 38% of non-demen ted people used psychotropic agents. Psychotropic use was higher in wo men and increased with institutionalization. Antipsychotic agents were used more by demented (22%) than by non-demented (3.5%) people: this was largely explained by differences in accommodation type. The odds r atio (OR) for use of antipsychotics by those in institutions compared with those living in their own homes was 9.32. Opioids were commonly p rescribed for demented people. The proportions taking opioids in those using analgesics were 42% in demented and 23% in nondemented people ( OR 2.07). Laxatives were used by 18% of the demented people in institu tions compared with 39% of non-demented people in institutions. Conclu sion: being in an institution had a stronger association with the use of certain drugs (e.g. psychotropics) than did dementia status. Dement ed people, especially those in institutions, used a large number of an tipsychotics and opioids, but fewer laxatives and minor analgesics. Pr escribers and institutional staff should be aware of these factors so they can optimize patient treatment.