Correlates of psychotropic drug use in the elderly compared to adults aged18-64: results from the Quebec Health Survey

This study documents correlates of psychotropic drug use among older adults and compares the results observed in this group to those observed in indiv iduals aged 18-64. A multivariate logistic regression analysis using data f rom the Quebec Health Survey (1992-1993) was employed to study predisposing and facilitating factors of this behavior. Results showed that 22% of the elderly reported having used anxiolytics, sedatives or hypnotics during the two days preceding the survey, compared to 4.9% of the respondents aged 18 -64. Combining both samples, perceived health status, physical functional s tatus, and health services utilization for psychological distress symptoms were the main health factors associated with psychotropic drug use. A signi ficant difference was observed between the two age groups with regard to th e association between the respondents' health status and the use of anxioly tics, sedatives or hypnotics. When the effect of other explanatory factors was controlled, older adults in poor health used anxiolytics, sedatives or hypnotics 2.21 times more than individuals aged 18-64 with a similar health condition, whereas older adults in good health used these drugs 7.49 times more than healthy individuals aged 18-64. Furthermore, after controlling f or the effect of the respondents' physical and psychological health status, our results showed that more women than men used psychotropic drugs (OR = 1.57; 99% CI = 1.26-1.94). Low-income respondents were also more likely to report using these medications (OR = 1.53; 99% CI = 1.22-1.90). These resul ts were interpreted as supporting the socio-cultural hypothesis of psychotr opic drug use, which suggests that the prescribing and utilization of psych otropic drugs is influenced not only by symptoms but also by the social cha racteristics of individuals. It is suggested that future research may contr ibute to a better understanding of psychotropic drug utilization in the old er adult community-dwelling population by examining consumers' attitudes an d health care providers' social values concerning the appropriateness of th is behavior.