OBJECTIVES: Despite the use of antipsychotics to treat dementia patients, the efficacy of the treatment is not well established. We examine factors associated with antipsychotics use among community-dwelling older persons with dementia. METHODS: We used data from The Aging, Demographics, and Memory Study (ADAMS) to assess dementia severity and service use from 2002 to 2004. We used logistic regressions to identify factors associated with antipsychotic use; N = 307. RESULTS: Among older persons with dementia living in community (weighted sample = 207,544), 7.8% (weighted sample = 16,272) took any antipsychotic medications; 69.1% were female, 70.7% were white, and 21.8% were African American. The average age was 85 years. Physical functions were measured by the number of ADL (average. 2.9) and number of IADL (mean 3.6). The most frequent primary diagnoses were Alzheimer's disease (74.3%), vascular dementia (16.0%) and other dementia (9.8%).The most frequently prescribed antipsychotics were: risperidone (58.0%), quetiapine (15.4%), and haloperidol (7.7%). Of those taking an antipsychotic, 86.0% were diagnosed with Alzheimer's dementia. We used the Neuropsychiatry Inventory (NPI) for behavior problems (delusions, hallucinations, agitation/aggression, depression, apathy, elation, anxiety, disinhibition, irritability/lability, and aberrant motor behavior). We evaluated severity of dementia using the Clinical Dementia Rating Scale (CDR).Communitydwelling older persons with dementia are significantly more likely to receive antipsychotics if they were agitated (OR = 3.4, P < 0.05), had disinhibition (OR = 4.6, P < 0.05), or had greater dementia severity (OR = 1.9, P < 0.01). Also, Medicaid recipients were significantly more likely to receive antipsychotic medications (OR = 5.4, P < 0.01). Participants were significantly less likely to be medicated with antipsychotics if they had vascular dementia (OR = 0.09, P < 0.05) or the caregivers were clinically depressed (OR = 0.2, P < 0.05). CONCLUSIONS: Community-dwelling older persons with dementia are more likely to receive antipsychotics if caregivers report behavior problems, the dementia is more advanced, and the patient has Medicaid coverage. Persons with vascular dementia are less likely to be treated with antipsychotics.
Rhee, Y., Shega, J., & Csernansky, J. (2011). PMH67 FACTORS ASSOCIATED WITH ANTIPSYCHOTICS USE AMONG COMMUNITY-DWELLING OLDER PERSONS WITH DEMENTIA. Value in Health, 13(7), A458. https://doi.org/10.1016/s1098-3015(11)72944-8