Wills P, Claesson C B, Fratiglioni L, Fastbom J, Thorslund M, Winblad B
Stockholm Gerontology Research Centre and Department of Geriatric Medicine, Karolinska Institute, Sweden.
Age Ageing. 1997 Sep;26(5):383-91. doi: 10.1093/ageing/26.5.383.
to determine the use of drugs by demented and non-demented elderly people in a population, by dementia status and type, age, sex and accommodation type.
data were obtained from the Kungsholmen project, a longitudinal community study of people over 75 in Stockholm, Sweden.
85% used at least one medicinal drug, and of these 12% were demented. Mean numbers of drugs used were 2.8 for demented and 3.2 for non-demented people. 45% of demented people and 38% of non-demented people used psychotropic agents. Psychotropic use was higher in women and increased with institutionalization. Antipsychotic agents were used more by demented (22%) than by non-demented (3.5%) people: this was largely explained by differences in accommodation type. The odds ratio (OR) for use of antipsychotics by those in institutions compared with those living in their own homes was 9.32. Opioids were commonly prescribed for demented people. The proportions taking opioids in those using analgesics were 42% in demented and 23% in non-demented people (OR 2.07). Laxatives were used by 18% of the demented people in institutions compared with 39% of non-demented people in institutions.
being in an institution had a stronger association with the use of certain drugs (e.g. psychotropics) than did dementia status. Demented people, especially those in institutions, used a large number of antipsychotics and opioids, but fewer laxatives and minor analgesics. Prescribers and institutional staff should be aware of these factors so they can optimize patient treatment.
根据痴呆状态和类型、年龄、性别及居住类型，确定某人群中患有痴呆症和未患痴呆症的老年人的用药情况。
数据取自瑞典斯德哥尔摩针对75岁以上人群开展的一项纵向社区研究—— Kungsholmen项目。
85%的人至少使用一种药物，其中12%患有痴呆症。痴呆症患者平均用药数量为2.8种，非痴呆症患者为3.2种。45%的痴呆症患者和38%的非痴呆症患者使用精神药物。女性精神药物使用率更高，且随着入住机构照料而增加。痴呆症患者（22%）使用抗精神病药物的比例高于非痴呆症患者（3.5%）：这在很大程度上可由居住类型差异来解释。与居家生活的人相比，机构照料的人使用抗精神病药物的比值比（OR）为9.32。阿片类药物常用于痴呆症患者。在使用镇痛药的人群中，痴呆症患者服用阿片类药物的比例为42%，非痴呆症患者为23%（OR 2.07）。机构照料的痴呆症患者中有18%使用泻药，而机构照料的非痴呆症患者中这一比例为39%。
与痴呆状态相比，入住机构照料与某些药物（如精神药物）的使用之间的关联更强。痴呆症患者，尤其是机构照料的患者，使用大量抗精神病药物和阿片类药物，但泻药和轻度镇痛药的使用较少。开处方者和机构工作人员应了解这些因素，以便优化患者治疗。
