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Prevalence and correlates of psychotropic drug use in Dutch nursing-home patients with dementia

  • Renate M. Nijk (a1) (a2), Sytse U. Zuidema (a1) and Raymond T. C. M. Koopmans (a1)
  • DOI:
  • Published online: 01 June 2009

Background: Neuropsychiatric symptoms in dementia patients are common and are often treated with psychotropic drugs. The aim of this study was to determine the prevalence and correlates of psychotropic drug use in Dutch nursing home patients with dementia.

Methods: Psychotropic drug use of 1322 patients on 59 dementia special care units (SCUs) in 25 nursing homes was registered. Drugs were categorized according to the Anatomical Therapeutical Chemical classification (ATC). The influence of age, gender, dementia stage measured by the Global Deterioration Scale (GDS), and type of neuropsychiatric symptoms on psychotropic drug use was analyzed using binomial logistic regression analysis.

Results: 63% of the patients used at least one psychotropic drug. Psychotropics in general and antipsychotics in particular were most frequently prescribed in GDS stage 6, and in patients aged between 65 and 75 years. Psychotropics in general were positively associated with depression, night-time behavior and agitation. Antipsychotic drug use was positively associated with psychosis, agitation and night-time behavior and was negatively associated with apathy. Anxiolytics were associated with age, psychosis, agitation and night-time behavior. Antidepressants were most frequently prescribed in GDS stage 6 and associated with female gender, agitation and depression. Sedatives were only associated with night-time behavior.

Conclusion: Nursing home patients with dementia have a high prevalence of psychotropic drug use. In particular, the association with neuropsychiatric symptoms raises questions of efficacy of these drugs and the risk of chronic use.

Corresponding author
Correspondence should be addressed to: R. M. Nijk, van Neynselgroep, P.O Box 90112, 5200 MA, 's Hertogenbosch, The Netherlands. Phone: +31 (0)73 658 3000, Fax: +31 (0)73 680 3060. Email:
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C. Ballard (2008). A randomised, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (the DART-AD Trial). PLoS Medicine, 5, 587599.

H. Brodaty , B. Draper , D. Saab , L. F. Low , V. Richards , H. Paton and D. Lie (2001). Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors. International Journal of Geriatric Psychiatry, 16, 504512.

J. Cohen-Mansfield and N. Billig (1986). Agitated behaviors in the elderly. I. A conceptual review. Journal of the American Geriatrics Society, 34, 711721.

J. F. de Jonghe and M. G. Kat (1996). Factor structure and validity of the Dutch version of the Cohen-Mansfield Agitation Inventory (CMAI-D). Journal of the American Geriatrics Society, 44, 888889.

J. Fossey (2006). Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial. BMJ, 332, 756761.

H. Kim and A. L. Whall (2006). Factors associated with psychotropic drug usage among nursing home residents with dementia. Nursing Research, 55, 252258.

J. Lindesay , R. Matthews and C. Jagger (2003). Factors associated with antipsychotic drug use in residential care: changes between 1990 and 1997. International Journal of Geriatric Psychiatry, 18, 511519.

C. G. Lyketsos , M. Steinberg , J. T. Tschanz , M. C. Norton , D. C. Steffens and J. C. Breitner (2000). Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging, American Journal of Psychiatry, 157, 708714.

A. J. Macdonald , G. I. Carpenter , O. Box , A. Roberts and S. Sahu (2002). Dementia and use of psychotropic medication in non-“Elderly Mentally Infirm” nursing homes in South East England. Age and Ageing, 31, 5864.

K. H. Pitkälä , J. V. Laurila , T. E. Strandberg and R. S. Tilvis (2004). Behavioral symptoms and the administration of psychotropic drugs to aged patients with dementia in nursing homes and in acute geriatric wards. International Psychogeriatrics, 16, 6174.

F. H. Ramadan , B. J. Naughton and R. Prior (2003). Correlates of behavioral disturbances and pattern of psychotropic medication use in five skilled nursing facilities. Journal of Geriatric Psychiatry and Neurology, 16, 814.

P. A. Rochon (2008). Antipsychotic therapy and short-term serious events in older adults with dementia. Archives of Internal Medicine, 168, 10901096.

L. S. Schneider , K. S. Dagerman and P. Insel (2005). Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA, 294, 19341943.

L. S. Schneider (2006). Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease. New England Journal of Medicine, 355, 15251538.

G. Selbaek , O. Kirkevold and K. Engedal (2007). The prevalence of psychiatric symptoms and behavioural disturbances and the use of psychotropic drugs in Norwegian nursing homes. International Journal of Geriatric Psychiatry, 22, 843849.

K. M. Sink , K. F. Holden and K. Yaffe (2005). Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. JAMA, 293, 596608.

M. B. van Iersel , S. U. Zuidema , R. T. C. M. Koopmans , F. R. J. Verhey and M. G. M. Olde Rikkert (2005). Antipsychotics for behavioural and psychological problems in elderly people with dementia: a systematic review of adverse events. Drugs and Aging, 22, 845858.

S. U. Zuidema , E Derksen ., F. R. J Verhey . and R. T Koopmans . (2007a). Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia. International Journal of Geriatric Psychiatry. 22, 632–238.

S. Zuidema , R. Koopmans and F. Verhey (2007b). Prevalence and predictors of neuropsychiatric symptoms in cognitively impaired nursing home patients. Journal of Geriatric Psychiatry and Neurology, 20, 4149.

S. U. Zuidema , J. F. de Jonghe , F. R. Verhey and R. T. Koopmans (2007c). Agitation in Dutch institutionalized patients with dementia: factor analysis of the Dutch version of the Cohen-Mansfield Agitation Inventory. Dementia and Geriatric Cognitive Disorders, 23, 3541.

S. U. Zuidema , J. F. de Jonghe , F. R. Verhey , and R. T. Koopmans (2007d). Neuropsychiatric symptoms in nursing home patients: factor structure invariance of the Dutch nursing home version of the neuropsychiatric inventory in different stages of dementia. Dementia and Geriatric Cognitive Disorders, 24, 169176.

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International Psychogeriatrics
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