Hartikainen Sirpa, Rahkonen Terhi, Kautiainen Hannu, Sulkava Raimo
Division of Geriatrics, Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland.
Int Clin Psychopharmacol. 2005 Jul;20(4):227-31. doi: 10.1097/00004850-200507000-00006.
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 hypnotics/sedatives. Seventy-one percent (n = 97) of demented elderly individuals used a psychotropic drug. Age- and sex-adjusted survival did not differ by severity of dementia (P = 0.076) or by the diagnosis of dementia (P = 0.54). When survival was compared with nonusers of psychotropics, the hazard ratio was 2.75 (P = 0.002) 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.
本研究旨在探讨精神药物的使用及其与老年痴呆患者生存情况的关系。1998年1月，从库奥皮奥市的人口中随机抽取了700名年龄在75岁及以上的个体。一名老年病科医生和一名护士对601名个体进行了临床检查，其中137人根据《精神疾病诊断与统计手册》第四版标准患有痴呆症。从1998年检查日期到2003年底计算寿命。在生存分析中，根据精神药物的使用情况将受试者分为两组：（i）仅使用一种精神药物的使用者和（ii）同时使用所有种类精神药物的使用者。精神药物分为抗精神病药、抗抑郁药以及一组抗焦虑药和催眠药/镇静剂。71%（n = 97）的老年痴呆患者使用了精神药物。年龄和性别调整后的生存率在痴呆症严重程度方面无差异（P = 0.076），在痴呆症诊断方面也无差异（P = 0.54）。当将生存率与未使用精神药物的患者进行比较时，仅将抗精神病药作为精神药物使用的个体危险比为2.75（P = 0.002），同时使用所有种类精神药物的使用者危险比为1.76（9５%置信区间1.09 - 2.86）。使用多种精神药物或抗精神病药是老年痴呆患者死亡的一个危险因素。
