Psychotropic drug use in community-dwelling people with young-onset dementia: two-year course and determinants

Figures & data

Table 1. Definition of prevalence rates and (dis)continuation of psychotropic drug use.

Prevalence rate	Number of persons with psychotropic drug use at assessment, percentage of total group (N = 174)
Continuation	Ratio of persons using psychotropic drugs at follow-up to those using on the previous assessments
Discontinuation	Ratio of persons using psychotropic drugs at one assessment but not at the next assessment
New onset	Persons using psychotropic drugs at the assessment but not at the previous assessment, percentage of total group (N = 174)
Two-year continuation rate	Number of persons who used psychotropic drugs at all assessments, percentage of total group (N = 174)
Cumulative use	Proportion of persons who received psychotropic drugs at baseline or during follow-up (N = 174)
Cumulative new onset	Proportion of persons who did use psychotropic drugs at one assessment but not at baseline (N = 174)

Table 2. Baseline findings.

	Total (N = 198)	Complete follow-up (N = 174)
Mean age, years (SD)	60.9 (5.5)	60.9 (5.6)
Sex, male N (%)	105 (53)	92 (52.9)
Dementia Subtypes
Alzheimer’s disease N (%)	122 (61.6)	106 (60.9)
Vascular dementia N (%)	34 (17.2)	31 (17.8)
Frontotemporal dementia N (%)	42 (21.2)	37 (21.3)
Dementia stage (GDS^a)	N = 183	N = 166
Mild N (%)	31 (16.9)	30 (18.1)
Moderate N (%)	120 (65.6)	112 (67.5)
Severe N (%)	32 (17.5)	24 (14.5)
Neuropsychiatric Inventory,^b mean	(N = 195)	(N = 171)
Psychosis (SD)	2.33 (4.5)	2.47 (4.6)
Hyperactivity (SD)	10.17 (10.9)	10.37 (11.0)
Affective symptoms (SD)	3.55 (4.9)	3.66 (4.9)
Apathy (SD)	8.84 (8.2)	8.80 (8.3)
Psychotropic Drug Use
Antipsychotics (N05A) N (%)	28 (14.4)	27 (15.5)
Anxiolytics (N05B) N (%)	18 (9.2)	16 (9.2)
Hypnotics/sedatives (N05C) N (%)	9 (4.6)	9 (5.2)
Antidepressants (N06A) N (%)	71 (36.4)	65 (37.4)
Antiepileptics (N03A) N (%)	9 (7.5)	9 (5.2)
Total psychotropic drug use^c N (%)	100 (50.5)	92 (52.9)

^aGDS = Global Deterioration Scale; mild (stage 2 + 3), moderate (4 + 5) and advanced (6 + 7).

^bNeuropsychiatric Inventory items were grouped into four neuropsychiatric sub-syndromes as suggested by the European Alzheimer Disease Consortium.

^cTotal psychotropic drug use = the use of at least one type of psychotropic drug.

Table 3. Course of psychotropic drug use (N = 174).

		First interval				Second interval				Third interval				Fourth interval
	T1^a	Continuation^b	Discontinuation^c	New onset^d	T2	Continuation^b	Discontinuation^c	New onset^d	T3	Continuation^b	Discontinuation^c	New onset^d	T4	Continuation^b	Discontinuation^c	New onset^d	T5
% Antipsychotics	15.5	81.5	18.5	8.8	20.1	80.0	20.0	5.8	20.7	97.2	2.8	10.1	28.2	79.6	20.4	6.4	27.0
% Anxiolytics	9.2	62.5	37.5	5.1	10.3	88.9	11.1	3.8	12.6	77.3	22.7	2.6	12.1	95.2	4.8	4.6	15.5
% Hypnotics/sedatives	5.2	66.7	33.3	1.8	5.2	55.6	44.4	3.6	6.3	72.7	27.3	1.2	5.7	60.0	40.0	1.2	4.6
% Antidepressants	37.4	87.7	12.3	5.5	36.2	87.3	12.7	8.1	36.8	90.6	9.4	8.2	38.5	95.5	4.5	12.1	44.3
% Antiepileptics	5.2	88.9	11.1	1.8	7.9	66.7	33.3	1.2	6.3	92.9	7.1	3.1	8.6	93.3	6.7	1.3	9.2
% Total psychotropic drug use^e	52.3				55.2				53.4				59.8				62.6

^aT1–T5: 6 months assessments, (T1 = baseline).

^bContinuation: the ratio of psychotropic drug users/users previous assessment.

^cDiscontinuation: the ratio of non-psychotropic drug users/users previous assessment.

^dNew onset: the ratio of psychotropic drug users/non-users at previous assessment.

^eTotal psychotropic drug use: the use of at least one type of psychotropic drug.

Table 4. Two-year psychotropic drug use (N = 174).

	Baseline	Two-year continuation	Cumulative
			Use^a	New onset^b
Antipsychotics N (%)	27 (15.5)	18 (10.3) [66.7]^c	37.4 %	21.3 %
Anxiolytics N (%)	16 (9.2)	8 (4.6) [50.0]^c	21.3 %	12.1 %
Hypnotics/sedatives N (%)	9 (5.2)	2 (1.1) [22.2]^c	11.5 %	6.3 %
Antidepressants N (%)	65 (37.4)	44 (25.3) [67.7]^c	51.7 %	14.4 %
Antiepileptics N (%)	9 (5.2)	4 (2.3) [44.4]^c	10.3 %	6.3 %
Total psychotropic drug use^d N (%)	91 (52.3)	65 (37.4) [72.2]^c	72.4 %	21.4 %

^aCumulative use: proportion who received psychotropic drugs at baseline or during follow-up.

^bCumulative new onset: proportion who did not use psychotropic drugs at baseline but at any of the next assessments.

^c[Percentage of baseline users].

^dTotal psychotropic drug use: the use of at least one type of psychotropic drugs.

Table 5. Two-year course of psychotropic drug use, Cox proportional hazard ratio’s (N = 174).

							95.0% CI for Exp(B)
	B	SE	Wald	df	Sig.	Exp(B)	Lower	Upper
Assessments
Baseline^a
6 months	.120	.109	1.198	1	.274	1.127	.910	1.397
12 months	.480	.122	.154	1	.695	1.049	.826	1.331
18 months	.315	.142	4.946	1	.026	1.370	1.038	1.808
24 months	.415	.146	8.073	1	.004	1.515	1.137	2.017
Age at baseline	.065	.026	6.419	1	.011	1.067	1.015	1.122
Sex, female	.338	.266	1.613	1	.204	1.402	.832	2.361

^aReference.

Table 6. Psychotropic drug use: univariate analysis.

	Use		Course^a
Determinants	Chi-Square (df)	p Value	Chi-Square (df)	p Value
Age	5.635 (1)	.018	1.426 (4)	.840
Gender	0.606 (1)	.436	1.772 (4)	.778
Diagnosis	0.249 (2)	.883	10.707 (8)	.219
GDS^b	2.755 (2)	.252	9.470 (8)	.304
NPI^c
Psychosis	2.188 (1)	.139	4.506 (4)	.342
Hyperactivity	2.398 (1)	.122	2.710 (4)	.607
Affective	0.643 (1)	.423	7.733 (4)	.102
Apathy	5.637 (1)	.018	4.492 (4)	.344

^aInteraction with time.

^bGlobal Deterioration Scale.

^cNeuropsychiatric Inventory.