Prevalence and correlates of psychotropic medication use among older adults in Israel: Cross-sectional and longitudinal findings from two cohorts a decade apart

Abstract

Objectives: To assess: (1) changes in use of psychotropic medications across two cohorts, 10 years apart, of community-dwelling elderly and the socio-demographic, physical and mental health correlates of their use; and (2) changes in psychotropic medication use over 3.5 years follow-up.

Methods: Data were taken from two national surveys of the Israeli Jewish population aged 75–94, which, respectively, sampled two cohorts in 1989 (n = 1200) and again in 1999 (n = 421). Psychotropic medications were assessed from the list of all medications recorded during a face-to-face interview. The current analysis focused on two medication groups: anxiolytics and sedatives/hypnotics and antidepressants.

Results: Sedatives/hypnotics and anxiolytics use increased from 22.2% in 1989 to 25.4% in 1999 and antidepressants from 3.8% to 4.8% (both nonsignificantly) corresponding to a decline in the health profile of community-dwelling older adults. Similar patterns of associations were observed for socio-demographics, physical, and mental health status indicators with the use of psychotropic medications across the two cohorts. The pooled multivariate analysis showed significantly higher use of sedative/hypnotics and anxiolytics among women and lower use among religious elderly. Additional risk factors were sleeping problems, number of other medications, depressive symptoms, and traumatic life events. Antidepressants use was related to a higher education, ADL disability, and depressive symptoms. Longitudinally, use of psychotropic medications was not significantly different among participants who were followed again after 3.5 years.

Conclusions: Sedative/hypnotics and anxiolytics use was relatively high while antidepressants use was low even among depressed elderly suggesting that some depressed elderly were treated inappropriately with benzodiazepines.

Keywords:

• psychotropic medications
• usage patterns
• epidemiology (mental health)
• community-dwelling

Acknowledgments

The CALAS was funded by the US National Institute on Aging (grants R01-AG05885-03 and R01-5885-06). The IMAS was funded by the Israel National Institute for Health Policy (grants A/2/1998 and R/2/2004). We are grateful to Esther Pollak and Bat Katzman for their valuable professional help concerning this study.