Differences in Psychotropic Drug Prescribing Between Ethnic Groups of People with Dementia in the United Kingdom

Figures & data

Table 1 Participant Characteristics of Cohort of Patients with Dementia, Total and by Each Ethnicity. As Ethnicity and Townsend Score of Social Deprivation Were Imputed and Sample Sizes Should Not Be Reported for Imputed Data, Only Percentages are Reported for Characteristics of Each Ethnicity and for Townsend Score

Characteristic	Number (%)	%	%	%
Ethnicity	All	White	Asian	Black
Patients	53,718	96.6%	2.2%	1.2%
Sex
Male	19,405 (36.1%)	35.9%	44.0%	40.0%
Age (years)
Mean (95% CI)	81.7 (81.6–81.8)	81.8 (81.7–81.9)	79.1 (78.4–79.8)	77.5 (76.5–78.4)
Median (IQR)	82.7 (76.6–87.8)
Female age: median (IQR)	84.3 (78.5–88.8)
Male age: median (IQR)	80.5 (74.5–85.5)
Age Category
50–59	1346 (2.5%)	2.4%	3.5%	7.2%
60–69	4118 (7.7%)	7.5%	10.9%	11.3%
70–79	14,344 (26.7%)	26.3%	36.7%	39.9%
80–89	25,216 (46.9%)	47.2%	40.0%	34.9%
90+	8694 (16.2%)	16.5%	9.0%	6.6%
Calendar Year
2014	40,620 (75.6%)	75.7%	71.9%	75.2%
2015	43,531 (81.0%)	81.1%	80.6%	79.4%
2016	32,989 (61.4%)	61.4%	62.7%	62.3%
Townsend Quintile
1 (least deprived)	22.2%	22.4%	16.8%	12.2%
2	24.0%	24.2%	21.2%	12.8%
3	21.7%	21.6%	22.2%	21.2%
4	19.3%	19.0%	26.7%	26.9%
5 (most deprived)	12.9%	12.7%	13.1%	26.8%
Follow-Up Time (years)
Mean (95% CI)	1.71 (1.70–1.72)	1.71 (1.70–1.72)	1.66 (1.60–1.73)	1.72 (1.63–1.81)
Prescribing Index	8.56 (8.53–8.58)	8.56 (8.53–8.58)	8.99 (8.81–9.18)	8.17 (7.87–8.47)
Diagnosis
Alzheimer’s disease	10,363 (19.3%)	19.3%	17.4%	19.9%
Mixed dementia	553 (1.0%)	1.0%	1.1%	0.9%
Vascular dementia	9731 (18.1%)	18.0%	22.6%	16.7%
Parkinson’s/Lewy body disease	723 (1.4%)	1.3%	1.5%	0.8%
Alcohol-related dementia	275 (0.5%)	0.5%	0.5%	0.5%
Other specified dementia	526 (1.0%)	1.0%	0.9%	1.0%
Frontotemporal dementia	10 (<0.1%)	n/a	n/a	n/a
Unspecified dementia	31,520 (58.7%)	58.7%	56.0%	60.1%

Table 2 Prevalence Rate Ratio and 95% Confidence Interval (CI) for Each of the Four Prescribing Outcomes in the Dementia Cohort (n=53,718). Results are Shown for Unadjusted Models and Models Adjusted for the Characteristics Listed

	Anti-Dementia Drugs, Not Contraindicated (n=43,786)			Anticholinergics			Antipsychotics			Anxiolytics/Hypnotics
	% Prescribed	Unadjusted	Adjusted	% Prescribed	Unadjusted	Adjusted	% Prescribed	Unadjusted	Adjusted	% Prescribed	Unadjusted	Adjusted
Ethnicity
White	48.1%	1	1	12.6%	1	1	21.5%	1	1	27.3%	1	1
Asian	37.6%	0.88 (0.78–1.01)	0.86 (0.76–0.98)	18.3%	1.48 (1.23–1.8)	1.43 (1.19–1.73)	19.0%	0.95 (0.79–1.14)	0.96 (0.79–1.15)	25.3%	1 (0.86–1.17)	1 (0.86–1.18)
Black	39.9%	0.93 (0.79–1.09)	0.91 (0.78–1.07)	11.5%	0.9 (0.65–1.26)	0.86 (0.62–1.2)	17.6%	0.95 (0.72–1.27)	0.97 (0.73–1.29)	15.0%	0.6 (0.44–0.8)	0.6 (0.44–0.8)
Sex
Female			0.94 (0.92–0.97)			1.09 (1.04–1.15)			0.95 (0.92–0.99)			0.99 (0.95–1.02)
Age
50–59			0.67 (0.61–0.75)			0.83 (0.71–0.98)			0.98 (0.86–1.12)			0.98 (0.87–1.09)
60–69			0.8 (0.75–0.84)			1.03 (0.94–1.12)			1.02 (0.95–1.1)			1.04 (0.98–1.11)
70–79			1			1			1			1
80–89			0.94 (0.91–0.97)			0.84 (0.8–0.89)			1.01 (0.96–1.05)			0.99 (0.95–1.03)
90–105			0.65 (0.62–0.68)			0.7 (0.64–0.76)			1.18 (1.11–1.25)			1.08 (1.02–1.13)
Townsend
1			1			1			1			1
2			0.95 (0.91–0.99)			1 (0.93–1.08)			1.01 (0.95–1.08)			0.98 (0.93–1.03)
3			0.94 (0.9–0.99)			1.01 (0.93–1.09)			1.05 (0.99–1.11)			1 (0.95–1.06)
4			0.94 (0.9–0.98)			1.06 (0.98–1.15)			0.97 (0.91–1.03)			1.01 (0.96–1.07)
5			0.89 (0.84–0.94)			1.01 (0.93–1.11)			0.99 (0.92–1.06)			1.01 (0.94–1.07)

Note: Statistically significant results are in bold.

Table 3 The Proportion and 95% Confidence Intervals (CI) of Time Spent on a Prescription in a Given Drug Category, in Days (Proportion of Time Multiplied by 365), Over the Time Under Follow-Up, in Years, for Each Ethnicity in the Dementia Cohort

	Anti-Dementia Drugs (N=22,435)			Antipsychotics (N=11,481)			Anxiolytics/Hypnotics (N=14,577)
	Ethnicity Prevalence	Days on Prescription per Year Follow-Up	95% CI	Ethnicity Prevalence	Days on Prescription per Year Follow-Up	95% CI	Ethnicity Prevalence	Days on Prescription per Year Follow-Up	95% CI
Ethnicity
White	97.3%	273.3	272.7–273.8	97.1%	173.8	172.2–175.3	97.3%	158.9	157.5–160.3
Asian	1.7%	258.2	255.4–260.4	1.9%	190.8	179.6–199.1	2.1%	147.6	137.3–155.4
Black	1.0%	272.6	267.3–276.7	1.0%	200.7	191.1–206.5	0.6%	165.8	147.3–176.8

Table 4 Prevalence Rate Ratio and 95% Confidence Interval (CI) for the Non-Dementia Cohort Prescribing Outcomes (n=1,648,889). Results are for Models Adjusted for Sex, Age Category, and Townsend Score

	Anticholinergics	Antipsychotics	Anxiolytics/Hypnotics
Ethnicity (reference is White)
Asian	0.91 (0.88–0.95)	0.84 (0.78–0.91)	0.85 (0.81–0.88)
Black	0.7 (0.65–0.75)	0.81 (0.72–0.91)	0.62 (0.58–0.67)
Sex
Female	1.73 (1.72–1.75)	1.13 (1.11–1.16)	1.52 (1.5–1.53)
Age
50–59	0.67 (0.66–0.67)	0.96 (0.93–0.99)	0.87 (0.86–0.88)
60–69	0.81 (0.8–0.83)	0.84 (0.81–0.87)	0.85 (0.84–0.87)
70–79	1	1	1
80–89	1.11 (1.09–1.13)	1.61 (1.55–1.67)	1.14 (1.12–1.16)
90–105	1.15 (1.11–1.19)	3.66 (3.46–3.86)	1.52 (1.47–1.57)
Townsend
1	1	1	1
2	1.08 (1.06–1.09)	1.21 (1.16–1.25)	1.06 (1.04–1.07)
3	1.22 (1.2–1.24)	1.48 (1.42–1.53)	1.15 (1.13–1.16)
4	1.44 (1.41–1.46)	1.94 (1.87–2.01)	1.28 (1.26–1.3)
5	1.68 (1.65–1.71)	2.6 (2.5–2.71)	1.48 (1.45–1.51)

Note: Statistically significant results are in bold.