Dementia, neuropsychiatric symptoms, and the use of psychotropic drugs among older people who receive domiciliary care: a cross-sectional study.

Abstract

BACKGROUND:

The objective of this study was to (a) determine the prevalence of cognitive impairment, dementia, and neuropsychiatric symptoms (NPSs) among home-dwelling people, 70 years and older (70+ years), who receive domiciliary care, and (b) describe their use of psychotropic drugs. Few studies have investigated dementia among people receiving in-home care.

METHODS:

A sample (N = 1,000) representative of people aged 70+ years receiving domiciliary care was randomly recruited for participation. A standardized interview with the participants and their next of kin were performed using well-established assessment scales. Two clinical experts independently diagnosed dementia according to ICD-10 criteria.

RESULTS:

Of the 415 participants (41.5%) with dementia according to ICD-10 criteria, 19.5% had a dementia diagnosis known to the patient themselves, their caregiver, or health workers in the domiciliary care service. In the previous month, 72.1% exhibited NPSs (21.1% rated as clinically significant), with depression (47.5%), apathy (33.7%), anxiety (33.0%), and irritability (31.1%) being the most common. Psychotropic drugs were regularly used by 40.1% of the sample. Antidepressants (p = 0.001) and cognitive enhancers (p < 0.001) were more often given to people with dementia than to those without dementia.

CONCLUSIONS:

Dementia and NPSs are highly prevalent among people who receive domiciliary care, and diagnostic disclosure is low. People with dementia constitute a distinct group with respect to NPSs and psychotropic drug use. Early detection and correct diagnosis might increase the understanding of their everyday challenges and enable families to alleviate consequences of dementia and NPSs.

• Authors: Jon N Wergeland, Geir Selbæk, Lisbeth D Høgset, Ulrika Söderhamn, Øyvind Kirkevold
• Journal: International psychogeriatrics (Int Psychogeriatr) Vol. 26 Issue 3 Pg. 383-91 (Mar 2014) ISSN: 1741-203X [Electronic] England
• PMID: 24252377 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents
• Nootropic Agents
• Psychotropic Drugs

Topics

• Aged
• Aged, 80 and over
• Antidepressive Agents (therapeutic use)
• Anxiety Disorders (diagnosis, drug therapy, epidemiology, psychology)
• Apathy (drug effects)
• Cross-Sectional Studies
• Dementia (diagnosis, drug therapy, epidemiology, psychology)
• Drug Utilization (statistics & numerical data)
• Female
• Home Care Services
• Humans
• Irritable Mood (drug effects)
• Male
• Neuropsychological Tests
• Nootropic Agents (therapeutic use)
• Norway
• Psychotropic Drugs (therapeutic use)