Abstract

Background:

Studies have shown declining use of potentially inappropriate medication (PIM), medication where risks associated with use outweigh potential benefits in older people. However, the trend in people with dementia remains unknown.

Objective:

To test the hypothesis that the use of PIM has decreased in people with dementia in line with the declining use in the general older population.

Methods:

Repeated cross-sectional register-based study of the entire Danish population aged ≥65 years (2000: N = 802,106; 2015: N = 1,056,476). PIM was identified using the Danish “Red-yellow-green list”. Changes in the use of PIM were examined by calculating the annual prevalence of filling prescriptions for at least one PIM in older people with and without dementia. Characteristics of the study population were examined annually including comorbidity.

Results:

From 2000 to 2015, the prevalence of PIM use decreased from 54.7%to 43.5%in people with dementia and from 39.5%to 28.8%in people without dementia; the decrease was significant across all age groups and remained so in a sensitivity analysis where antipsychotics were removed. During the same period, comorbidity scores increased in people with and without dementia.

Conclusion:

The declining use of PIM in people with dementia from 2000 to 2015 parallels the trend in the general older population. The use of PIM decreased despite increasing levels of comorbidity and was not solely attributable to the decreasing use of antipsychotics in people with dementia. However, PIM use remained more widespread in people with dementia who may be more vulnerable to the risks associated with PIM.

中文翻译：

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2000 年至 2015 年痴呆症患者使用潜在不适当药物的情况减少：一项基于全国登记的重复横断面研究

 抽象的

 背景：

研究表明，潜在不适当药物 (PIM) 的使用正在减少，这种药物对老年人来说，使用带来的风险超过了潜在的益处。然而，痴呆症患者的趋势仍然未知。

 客观的：

检验以下假设：痴呆症患者中 PIM 的使用量有所减少，与一般老年人群中 PIM 使用量的下降一致。

 方法：

对年龄≥65 岁的整个丹麦人口进行重复横断面登记研究（2000 年：N = 802,106；2015 年：N = 1,056,476）。 PIM使用丹麦“红黄绿清单”进行识别。通过计算患有或不患有痴呆症的老年人每年服用至少一种 PIM 处方的流行率来检查 PIM 使用的变化。每年检查研究人群的特征，包括合并症。

 结果：

从2000年到2015年，痴呆症患者的PIM使用率从54.7%下降到43.5%，非痴呆症患者的PIM使用率从39.5%下降到28.8%；在所有年龄组中，这种下降都很显着，并且在去除抗精神病药物的敏感性分析中仍然如此。在同一时期，患有和未患有痴呆症的人的合并症评分都有所增加。

 结论：

2000 年至 2015 年间，痴呆症患者 PIM 使用率下降，与一般老年人群的趋势一致。尽管合并症水平增加，但 PIM 的使用却有所减少，这不仅仅归因于痴呆症患者抗精神病药物的使用减少。然而，PIM 在痴呆症患者中的使用仍然更为广泛，他们可能更容易受到与 PIM 相关的风险的影响。