Psychotropic drug use in community-dwelling elderly people-characteristics of persistent and incident users.

purposeThe aim of this prospective cohort study was to analyze psychotropic drug use in community-dwelling elderly people over a 3-year period and characterize those individuals most susceptible to persistent and incident use.

methodsData on demographics, health status, cognition, functional capacity and drug use were gathered by interviews at baseline (2004) and in three follow-ups (2005-2007) in a population-based sample of 700 community-dwelling people aged ≥75 years. Characteristics associated with persistent and incident use were identified using Cox proportional-hazards regression.

resultsAt baseline, 38% (n = 269) of the participants used psychotropic drugs. Of these, 60% (n = 162) reported use in all three follow-ups, whereas 22% (n = 59) discontinued use. Among the baseline users of antipsychotics (n = 40), antidepressants (n = 83) and benzodiazepines (n = 219), respectively, 43, 51 and 55% reported use in all three follow-ups. The characteristics associated with persistent use of psychotropic drugs included concomitant use of psychotropic drugs, regular use of psychotropic drugs, increasing age and good self-rated health. Among the baseline nonusers of psychotropic drugs (n = 431), 20% (n = 88) initiated use during the follow-up. Incident use of psychotropic drugs was associated with increasing Geriatric Depression Scale scores, a Mini-Mental State Examination score ≤24, number of visits to physician ≥ 6, moderate/poor self-rated health and moderate/poor life satisfaction.

conclusionsPsychotropic drugs, benzodiazepines in particular, are frequently used for extended periods in community-dwelling people aged ≥75 years. Individuals with multiple psychotropic drugs and a regular pattern of use are most susceptible to persistent use. Characteristics associated with incident use include depressive symptoms, cognitive decline and poor general health.