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Psychotropic Use in Elderly with Cognitive Impairment Living in Nursing Homes

Published online by Cambridge University Press:  23 March 2020

A.R. Ferreira ,
S. Martins ,
C. Dias ,
M.R. Simões  and
L. Fernandes
A.R. Ferreira
Affiliation:
PhD Program in Clinical and Health Services Research/PDICSS, Health Information and Decision Sciences Department, Faculty of Medicine, University of Porto, Porto, Portugal CINTESIS–Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
S. Martins*
Affiliation:
CINTESIS–Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
C. Dias
Affiliation:
Health Information and Decision Sciences Department, FMUP, Center for Health Technology and Services Research/CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal
M.R. Simões
Affiliation:
Psychological Assessment Laboratory, CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
L. Fernandes
Affiliation:
Department of Clinical Neuroscience and Mental Health, CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal
*
*Corresponding author.

Abstract

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Introduction

Elderly patients in nursing homes (NH) are often prescribed medications for many physical and mental health problems, with polypharmacy. There is a considerable number of studies documenting this extensive prescription of psychotropic medication, despite the raised concerns about their overuse/misuse, due to serious adverse effects, including increased rate of cognitive decline associated with antipsychotics.

Aims

To characterize the prescription of psychotropics in elderly sample with cognitive impairment living in NH.

Methods

Elderly living in three Portuguese NH were included in this cross-sectional study. All residents were eligible, unless they were unwilling or unresponsive. Participants’ medication was obtained from medical records. Guidelines of ATC were used to categorize the drugs. Participants were assessed with MMSE and GDS.

Results

The sample included 172 elderly, mostly women (90%), with average of 81(sd = 10) years and median lengths of stay of 3 years. Overall, 79.1% used ≥ 1 nervous system-acting drugs. Anxiolytics (54.7%), antidepressants (29.1%) and antipsychotics (23.3%) were the most frequent. The majority (58%) presented cognitive impairment (MMSE). Among those, 46.2% presented depression (GDS) and 79.6% took at least one drug for the CNS and 41.9% ≥ 3. Antipsychotics were received by 26.5%, while 57.1% used anxiolytics, 31.6% antidepressants and 16.3% anti-dementia drugs. No significant relation between GDS and antidepressants was found.

Conclusion

This study confirms the high usage of CNS drugs in patients with cognitive impairment in NH. These rates were comparable with previous studies. Antidepressants appear to be under-used, which can be related to the under-recognition of depression. Also, potential harmful psychotropic drugs such as anxiolytics and antipsychotics are overused.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster walk: Old-age psychiatry
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S174
Copyright
Copyright © European Psychiatric Association 2017
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