Differences in drug therapy between dementia disorders in the Swedish dementia registry: a nationwide study of over 7,000 patients

Dement Geriatr Cogn Disord. 2013;35(5-6):239-48. doi: 10.1159/000348408. Epub 2013 Mar 7.

Abstract

Background/aims: We aimed to study whether there are differences between dementia disorders and the use of anti-dementia drugs and antipsychotics (neuroleptics) in a large population of dementia patients.

Methods: Information about dementia disorders was obtained from the national Swedish Dementia Registry (SveDem) 2007-2010 (n = 7,570). Multivariate logistic regression analysis was performed to investigate the association between dementia disorders and the use of anti-dementia drugs and antipsychotics, after adjustment for age, sex, residential setting, living alone, MMSE score and number of other drugs (a proxy for overall co-morbidity).

Results: More than 80% of the Alzheimer's disease (AD) and 86% of dementia with Lewy bodies (DLB) patients used anti-dementia drugs. Women were more likely than men to be treated with cholinesterase inhibitors. A higher MMSE score was positively associated with the use of cholinesterase inhibitors, but negatively associated with NMDA receptor antagonists and antipsychotics. Use of antipsychotics was 6% overall; however, it was 16% in DLB patients with an adjusted odds ratio of 4.2 compared to AD patients.

Conclusion: Use of anti-dementia drugs in AD was in agreement with Swedish guidelines. However, use of antipsychotics in DLB patients was high, which might be worrying given the susceptibility of DLB patients to antipsychotics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / psychology
  • Antipsychotic Agents / therapeutic use
  • Dementia / drug therapy*
  • Dementia / epidemiology
  • Dementia / psychology
  • Dementia, Vascular / epidemiology
  • Dementia, Vascular / psychology
  • Female
  • Humans
  • Institutionalization
  • International Classification of Diseases
  • Lewy Body Disease / drug therapy
  • Logistic Models
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Nootropic Agents / therapeutic use
  • Registries
  • Sweden / epidemiology

Substances

  • Antipsychotic Agents
  • Nootropic Agents