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BMC Pharmacology and Toxicology

, 18:36

Clinical pharmacology


Background Psychotropic drugs are common among old people with dementia, and have been associated with increased mortality. Previous studies have not investigated sex differences in this risk. This study was conducted to analyse associations between the use of antipsychotics, antidepressants, and benzodiazepines and 2-year mortality in old people with dementia, and to investigate sex differences therein.

MethodsIn total, 1037 participants 74% women; mean age, 89 years with dementia were included from four cohort studies and followed for 2 years. Data were collected through home visits and medical records. Cox proportional hazard regression models were used to analyse associations between ongoing baseline drug use and mortality. Multiple possible confounders were evaluated and adjusted for.

ResultsIn fully adjusted models including data from the whole population, no association between baseline psychotropic drug use and increased 2-year mortality was seen. Significant sex differences were found in mortality associated with antidepressant use, which was protective in men, but not in women hazard ratio HR 0.61, 95% confidence interval CI 0.40–0.92 and HR 1.09, 95% CI 0.87–1.38, respectively. The interaction term for sex was significant in analyses of benzodiazepine use, with a higher mortality risk among men than among women.

ConclusionsAmong old people with dementia, ongoing psychotropic drug use at baseline was not associated with increased mortality in analyses adjusted for multiple confounders. Sex differences in mortality risk associated with antidepressant and benzodiazepine use were seen, highlighting the need for further investigation of the impact of sex.

KeywordsAlzheimer’s disease Antidepressants Antipsychotics Benzodiazepines Cohort study Dementia Gender Mortality Old age Psychotropic drugs Vascular dementia AbbreviationsADLActivities of daily living

ATCAnatomical Therapeutic Chemical index

BMIBody mass index

BPSDBehavioural and psychological symptoms of dementia

CIConfidence interval

FOPANUFrail Older People–Activity and Nutrition

GDS-1515-item version of the Geriatric Depression Scale

GERDAUmeå 85+-Gerontological Regional Database

HRHazard ratio

MMSEMini-Mental State Examination

MNAMini Nutritional Assessment

OROdds ratio

REMANUResidential Care Facilities–Mobility, Activity and Nutrition

UMDEXUmeå Dementia and Exercise

Electronic supplementary materialThe online version of this article doi:10.1186-s40360-017-0142-9 contains supplementary material, which is available to authorized users.

Autor: Jon Brännström - Gustaf Boström - Erik Rosendahl - Peter Nordström - Håkan Littbrand - Hugo Lövheim - Yngve Gustafson


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