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Behavioral disturbances and pharmacological treatment of patients with dementia in family caregiving : A 2-year follow-up

Elmståhl, Sölve LU ; Stenberg, Ingegerd ; Annerstedt, Lena and Ingvad, Bengt LU (1998) In International Psychogeriatrics 10(3). p.239-252
Abstract

Behavioral disturbances are common in dementia. Polypharmacy due to progression of disease and fluctuation of symptoms among patients might increase risk of overtreatment and/or undertreatment. Drug prescription habits were studied in relationship to symptoms of dementia after relocation of patients to group-living care units (GC). Seventy-six demented patients (mean age 81 years) were assessed before, 12 months after, and 24 months after relocation to GC. Vascular dementia was found in 47%, Alzheimer's dementia in 46%, and other dementias in 7%. Medications, regular or as required, were recorded from medication lists. Repeated observations of symptoms like depressive mood and lack of vitality were made with validated scales. Eighty... (More)

Behavioral disturbances are common in dementia. Polypharmacy due to progression of disease and fluctuation of symptoms among patients might increase risk of overtreatment and/or undertreatment. Drug prescription habits were studied in relationship to symptoms of dementia after relocation of patients to group-living care units (GC). Seventy-six demented patients (mean age 81 years) were assessed before, 12 months after, and 24 months after relocation to GC. Vascular dementia was found in 47%, Alzheimer's dementia in 46%, and other dementias in 7%. Medications, regular or as required, were recorded from medication lists. Repeated observations of symptoms like depressive mood and lack of vitality were made with validated scales. Eighty percent of the patients were prescribed drugs; 40% were given neuroleptics and 9% were given antidepressants. During the 2-year follow-up, polypharmacy increased; patients with five drugs or more increased from 15% to 35%; usage of neuroleptics or sedatives, as required, increased from 8% to 25%, p < .01. Depressive mood was noted in 86% after 2 years and 74% showed aggressiveness and anxiety, but only 12% of the patients with depressive symptoms were on antidepressants. Analgesics were prescribed to 26% of patients. In conclusion, a high proportion of patients with dementia had depressive mood and undertreatment of depressive disorder might be suspected. Polypharmacy increased during the 2-year follow-up; this finding calls for careful monitoring of adverse drug reactions, because of the deteriorating cognitive function of these patients.

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Contribution to journal
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published
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in
International Psychogeriatrics
volume
10
issue
3
pages
14 pages
publisher
Cambridge University Press
external identifiers
  • scopus:0031688090
  • pmid:9785145
ISSN
1041-6102
DOI
10.1017/S1041610298005353
language
English
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yes
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40f2f79f-835e-4746-8dbe-259c464f201c
date added to LUP
2019-06-19 10:34:43
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2021-02-17 04:51:45
@article{40f2f79f-835e-4746-8dbe-259c464f201c,
  abstract     = {<p>Behavioral disturbances are common in dementia. Polypharmacy due to progression of disease and fluctuation of symptoms among patients might increase risk of overtreatment and/or undertreatment. Drug prescription habits were studied in relationship to symptoms of dementia after relocation of patients to group-living care units (GC). Seventy-six demented patients (mean age 81 years) were assessed before, 12 months after, and 24 months after relocation to GC. Vascular dementia was found in 47%, Alzheimer's dementia in 46%, and other dementias in 7%. Medications, regular or as required, were recorded from medication lists. Repeated observations of symptoms like depressive mood and lack of vitality were made with validated scales. Eighty percent of the patients were prescribed drugs; 40% were given neuroleptics and 9% were given antidepressants. During the 2-year follow-up, polypharmacy increased; patients with five drugs or more increased from 15% to 35%; usage of neuroleptics or sedatives, as required, increased from 8% to 25%, p &lt; .01. Depressive mood was noted in 86% after 2 years and 74% showed aggressiveness and anxiety, but only 12% of the patients with depressive symptoms were on antidepressants. Analgesics were prescribed to 26% of patients. In conclusion, a high proportion of patients with dementia had depressive mood and undertreatment of depressive disorder might be suspected. Polypharmacy increased during the 2-year follow-up; this finding calls for careful monitoring of adverse drug reactions, because of the deteriorating cognitive function of these patients.</p>},
  author       = {Elmståhl, Sölve and Stenberg, Ingegerd and Annerstedt, Lena and Ingvad, Bengt},
  issn         = {1041-6102},
  language     = {eng},
  month        = {09},
  number       = {3},
  pages        = {239--252},
  publisher    = {Cambridge University Press},
  series       = {International Psychogeriatrics},
  title        = {Behavioral disturbances and pharmacological treatment of patients with dementia in family caregiving : A 2-year follow-up},
  url          = {http://dx.doi.org/10.1017/S1041610298005353},
  doi          = {10.1017/S1041610298005353},
  volume       = {10},
  year         = {1998},
}