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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从 2000 年到 2015 年，痴呆症患者潜在不适当药物的使用减少：一项重复的、基于全国注册的横断面研究

摘要

背景：

研究表明，潜在不适当药物 (PIM) 的使用减少，这些药物的使用风险超过了老年人的潜在益处。然而，痴呆症患者的趋势仍然未知。

客观的：

检验以下假设：痴呆症患者的 PIM 使用量下降，与一般老年人口使用量的下降一致。

方法：

对整个丹麦 65 岁以上人口进行的重复横断面登记研究（2000 年：N = 802,106；2015 年：N = 1,056,476）。PIM 是使用丹麦语“红-黄-绿列表”确定的。通过计算患有和不患有痴呆症的老年人中至少一种 PIM 的年度流行率来检查 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%，非痴呆症患者从 39.5% 下降到 28.8%；所有年龄组的下降都很显着，在去除抗精神病药的敏感性分析中仍然如此。在同一时期，患有和不患有痴呆症的人的合并症评分增加。

结论：

从 2000 年到 2015 年，痴呆症患者使用 PIM 的下降与一般老年人口的趋势相似。尽管合并症水平增加，但 PIM 的使用有所减少，这并不仅仅归因于痴呆症患者中抗精神病药物的使用减少。然而，PIM 的使用在痴呆症患者中仍然更普遍，他们可能更容易受到 PIM 相关风险的影响。