The use of psychotropics and survival in demented elderly individuals

The present study aimed to examine the use of psychotropics and its relation to survival in demented elderly persons. A random sample of 700 individuals, aged 75 years or older, was drawn from the population of Kuopio city in January 1998. A geriatrician and a nurse carried out clinical examinations of 601 individuals, of whom 137 suffered from dementia according to DSM-IV criteria. The lifespan was calculated from the date of examination in 1998 to the end of 2003. In survival analyses, subjects were divided according to psychotropic use into groups (i) users of only one of kind of psychotropics and (ii) concomitant users of all kinds of psychotropics. Psychotropics were classified into antipsychotics, antidepressants and a group of anxiolytics and hypnoticssedatives. Seventy-one percent (n97) of demented elderly individuals used a psychotropic drug. Age- and sex-adjusted survival did not differ by severity of dementia (P0.076) or by the diagnosis of dementia (P0.54). When survival was compared with nonusers of psychotropics, the hazard ratio was 2.75 (P0.002) for individuals who used antipsychotics as their only psychotropic medicine and 1.76 (95 confidence interval 1.09–2.86) for concomitant users of all kinds of psychotropics. The use of several psychotropics or antipsychotics is a risk factor for death in demented elderly persons.