Linjakumpu T, Hartikainen S, Klaukka T, Koponen H, Kivelä S-L, Isoaho R
Department of Psychiatry, University of Oulu, Oulu, Finland.
Int J Geriatr Psychiatry. 2002 Sep;17(9):874-83. doi: 10.1002/gps.712.
To assess the level of and changes in the use of psychotropics among the home-dwelling elderly in the 1990s.
A descriptive analysis based on data from two cross-sectional interview and health examination surveys of elderly persons aged 64 years or over conducted in Lieto, a typical semi-rural Finnish municipality, in 1990-91 and 1998-99. National prescription data were utilized to compare the use of psychotropics in the late 1990s by all Finnish home-dwelling elderly and the elderly in Lieto. In Lieto drug information was obtained from 1131 persons in 1990-91 and from 1197 in 1998-99, and the mean age of the informants was 73 years in both surveys. The brand names of the prescription drugs (both irregular and regular medication) taken by each interviewee during seven days prior to the interview were recorded and categorized by the Anatomical Therapeutic Chemical (ATC) classification system.
Every fourth person was taking at least one psychotropic drug in both surveys. Most users were on regular psychotropic medication. The use of hypnotics and antidepressants increased most during the study period. Polypharmacy and the use of psychotropics were most prevalent among those aged 85 years or over, with women predominating. Concomitant use of two or more psychotropics increased statistically significantly from 7% to 10% between the surveys. The young elderly, aged 64-71 years, used cyclic antidepressants equally commonly in both surveys. None of the young elderly used new atypical antipsychotics in 1998-99.
Psychotropics tend to be overprescribed and overused among the elderly, a group at the highest risk of adverse drug reactions. The tendency of prescribing for the elderly is not going in a better direction. New-generation psychotropics were not used. The need for long-standing use of psychotropics should be assessed regularly.
评估20世纪90年代居家老年人使用精神药物的水平及变化情况。
基于1990 - 91年和1998 - 99年在芬兰典型半乡村市镇列托对64岁及以上老年人进行的两次横断面访谈和健康检查调查数据进行描述性分析。利用全国处方数据比较20世纪90年代末所有芬兰居家老年人和列托老年人精神药物的使用情况。在列托，1990 - 91年从1131人获取药物信息，1998 - 99年从1197人获取，两次调查中信息提供者的平均年龄均为73岁。记录每位受访者在访谈前七天服用的处方药（包括非正规和正规用药）的品牌名称，并根据解剖治疗化学（ATC）分类系统进行分类。
两次调查中每四人中就有一人至少服用一种精神药物。大多数使用者服用的是正规精神药物。在研究期间，催眠药和抗抑郁药的使用增加最多。多重用药和精神药物的使用在85岁及以上人群中最为普遍，女性居多。两次调查之间同时使用两种或更多种精神药物的比例从7%增至10%，有统计学显著差异。64 - 71岁的年轻老年人在两次调查中使用环性抗抑郁药的情况相同。1998 - 99年，没有年轻老年人使用新型非典型抗精神病药物。
精神药物在老年人中往往存在过度处方和过度使用的情况，而老年人是药物不良反应风险最高的群体。对老年人的处方趋势并未朝着更好的方向发展。未使用新一代精神药物。应定期评估长期使用精神药物的必要性。
