Título
Disparities by socioeconomic status and diagnosis of dementia in the prescribing of antipsychotics in a real-World data population over 60 years of ageAutor-a
Autor-a (de otra institución)
Otras instituciones
OsakidetzaUniversidad Carlos III de Madrid
Versión
Version publicada
Derechos
© 2024 The AuthorsAcceso
Acceso abiertoVersión del editor
https://doi.org/10.3233/JAD-240004Publicado en
Journal of Alzheimer's Disease Primera página
645Última página
655Editor
IOS PressPalabras clave
Alzheimer’s disease
antipsychotics agents
Comorbidity
dementia ... [+]
antipsychotics agents
Comorbidity
dementia ... [+]
Alzheimer’s disease
antipsychotics agents
Comorbidity
dementia
disparities
nursing home
quetiapine fumarate
Social inequality
ODS 3 Salud y bienestar [-]
antipsychotics agents
Comorbidity
dementia
disparities
nursing home
quetiapine fumarate
Social inequality
ODS 3 Salud y bienestar [-]
Materia (Tesauro UNESCO)
Estadísticas sanitariasEpidemiología
Clasificación UNESCO
EpidemiologíaSalud pública
Resumen
Background:
Antipsychotics are widely used in the elderly due to the high prevalence of neuropsychiatric associated with dementia.
Objective:
To analyze potential disparities in antipsychotic use ... [+]
Background:
Antipsychotics are widely used in the elderly due to the high prevalence of neuropsychiatric associated with dementia.
Objective:
To analyze potential disparities in antipsychotic use in the general population of Gipuzkoa by socioeconomic status (SES) and diagnosis of Alzheimer’s disease and related dementia (ADRD) adjusting for somatic and psychiatric comorbidities, age, and sex.
Methods:
A retrospective observational study was carried out in all the 221,777 individuals over 60 years of age (Gipuzkoa, Spain) to collect diagnosis of ADRD, the Charlson Comorbidity Index, and psychiatric comorbidities considering all primary, outpatient, emergency and inpatient care episodes and first- and second-generation antipsychotics, and sociodemographic variables, namely, age, sex, SES and living in a nursing home. Logistic regression was used for multivariate statisticalanalysis.
Results:
Use of any antipsychotic was greater in women, individuals over 80 years old, living in a nursing home, with a diagnosis of dementia, somatic and psychiatric comorbidities, and low SES. Quetiapine was the most used drug. The likelihood of any antipsychotic use was significantly associated with low SES (odds ratio [OR]: 1.60; confidence interval [CI]: 1.52–1.68), age over 80 years (OR: 1.56; CI: 1.47–1.65), institutionalization (OR: 12.61; CI: 11.64–13.65), diagnosis of dementia (OR: 10.18; CI: 9.55–10.85) and the comorbidities of depression (OR: 3.79; CI: 3.58–4.01) and psychosis (OR: 4.96; CI: 4.64–5.30).
Conclusions:
The greater levels of antipsychotic use and institutionalization in people of low SES indicate inequity in the management of neuropsychiatric symptoms. Increasing the offer of non-pharmacological treatments in the health system might help reduce inequity. [-]
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