Axmon Anna, Kristensson Jimmie, Ahlström Gerd, Midlöv Patrik
Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE 221 00 Lund, Sweden.
Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
Res Dev Disabil. 2017 Mar;62:50-57. doi: 10.1016/j.ridd.2017.01.001. Epub 2017 Jan 18.
Although people with intellectual disability (ID) and people with dementia have high drug prescription rates, there is a lack of studies investigating drug use among those with concurrent diagnoses of ID and dementia.
To investigate the use of antipsychotics, benzodiazepine derivatives, and drugs recommended for dementia treatment (anticholinesterases [AChEIs] and memantine) among people with ID and dementia.
Having received support available for people with ID and/or autism spectrum disorder (ASD) was used as a proxy for ID. The ID cohort consisted of 7936 individuals, aged at least 55 years in 2012, and the referent cohort of age- and sex-matched people from the general population (gPop). People with a specialists' diagnosis of dementia during 2002-2012 were identified (ID, n=180; gPop, n=67), and data on prescription of the investigated drugs during the period 2006-2012 were collected.
People with ID/ASD and dementia were more likely than people with ID/ASD but without dementia to be prescribed antipsychotics (50% vs 39% over the study period; odds ratio (OR) 1.85, 95% confidence interval 1.13-30.3) and benzodiazepine derivatives (55% vs 36%; OR 2.42, 1.48-3.98). They were also more likely than people with dementia from the general population to be prescribed antipsychotics (50% vs 25%; OR 3.18, 1.59-6.34), but less likely to be prescribed AChEIs (28% vs 45%; OR 0.32, 0.16-0.64).
尽管智障人士和痴呆症患者的药物处方率很高，但缺乏对同时患有智障和痴呆症的人群用药情况的研究。
调查智障和痴呆症患者中抗精神病药物、苯二氮䓬衍生物以及推荐用于治疗痴呆症的药物（抗胆碱酯酶药[AChEIs]和美金刚）的使用情况。
将获得针对智障和/或自闭症谱系障碍（ASD）患者的支持作为智障的替代指标。智障队列由7936名个体组成，他们在2012年至少55岁，对照队列是来自普通人群（gPop）的年龄和性别匹配的人群。确定了在2002年至2012年期间被专科医生诊断为痴呆症的患者（智障队列，n = 180；普通人群队列，n = 67），并收集了2006年至2012年期间所调查药物的处方数据。
患有智障/ASD和痴呆症的患者比患有智障/ASD但无痴呆症的患者更有可能被开具抗精神病药物（在研究期间分别为50%和39%；优势比[OR]为1.85，95%置信区间为1.13 - 30.3）和苯二氮䓬衍生物（分别为55%和36%；OR为2.42，1.48 - 3.98）。他们也比普通人群中患有痴呆症的患者更有可能被开具抗精神病药物（分别为50%和25%；OR为3.18，1.59 - 6.34），但被开具抗胆碱酯酶药的可能性较小（分别为28%和45%；OR为0.32，0.16 - 0.64）。
