Moga Daniela C, Taipale Heidi, Tolppanen Anna-Maija, Tanskanen Antti, Tiihonen Jari, Hartikainen Sirpa, Wu Qishan, Jicha Gregory A, Gnjidic Danijela
Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Room 241, 789 South Limestone Street, Lexington, KY, 40536-0596, USA.
Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA.
Drugs Aging. 2017 Jan;34(1):55-65. doi: 10.1007/s40266-016-0419-5.
Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer's disease (AD) living in the US and Finland.
We used data collected between 2005 and 2011 as part of the National Alzheimer's Coordinating Center (NACC) in the US, and Medication use and Alzheimer's disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable logistic regression adjusted for demographics, co-morbidities, and other medications to estimate the magnitude of the association (adjusted odds ratio [aOR] with 95% confidence intervals [CIs]) according to sex.
We included 1099 NACC participants (502 [45.68%] men, 597 [54.32%] women), and 67,049 participants from the MEDALZ cohort (22,961 [34.24%] men, 44,088 [65.75%] women). Women were more likely than men to use psychotropic medications: US, 46.2% vs. 33.1%, p < 0.001; Finland, 45.3% vs. 36.1%, p < 0.001; aOR was 2.06 (95% CI 1.58-2.70) in the US cohort and 1.38 (95% CI 1.33-1.43) in the Finnish cohort. Similarly, of the different psychotropic medications, women were more likely to use antidepressants (aOR-US: 2.16 [1.44-3.25], Finland: 1.52 [1.45-1.58]) and anxiolytics (aOR-US: 2.16 [1.83-3.96], Finland: 1.17 [1.13-1.23]) than men.
Older women with AD are more likely to use psychotropic medications than older men, regardless of study population and country. Approaches to mitigate psychotropic medication use need to consider different prescribing habits observed in older women vs. men with AD.
鉴于痴呆症患者中精神药物使用的高患病率以及男性和女性不同的处方习惯，我们的研究旨在调查在美国和芬兰生活的患有阿尔茨海默病（AD）的老年人在精神药物使用方面的性别差异。
我们使用了2005年至2011年期间收集的数据，这些数据是美国国家阿尔茨海默病协调中心（NACC）以及芬兰药物使用与阿尔茨海默病（MEDALZ）队列研究的一部分。我们评估了65岁及以上参与者的精神药物使用情况（抗抑郁药、抗精神病药、抗焦虑药、镇静剂或催眠药）。我们采用多变量逻辑回归，并对人口统计学、合并症和其他药物进行了调整，以根据性别估计关联强度（调整后的优势比[aOR]及95%置信区间[CI]）。
我们纳入了1099名NACC参与者（男性502名[45.68%]，女性597名[54.32%]），以及来自MEDALZ队列的67049名参与者（男性22961名[34.24%]，女性44088名[65.75%]）。女性比男性更有可能使用精神药物：在美国，分别为46.2%和33.1%，p<0.001；在芬兰，分别为45.3%和36.1%，p<0.001；在美国队列中，aOR为2.06（95%CI 1.58 - 2.70），在芬兰队列中为1.38（95%CI 1.33 - 1.43）。同样，在不同的精神药物中，女性比男性更有可能使用抗抑郁药（美国aOR：2.16[1.44 - 3.25]，芬兰：1.52[1.45 - 1.
