The Use of Opioids and Antipsychotics in Elderly with Dementia - Have Opioids Replaced Antipsychotics in Treating Behavioral Symptoms in Dementia?
J Alzheimers Dis
; 73(1): 259-267, 2020.
Article
em En
| MEDLINE
| ID: mdl-31771062
ABSTRACT
BACKGROUND:
Opioids are used with increasing frequency. Elderly with dementia are prescribed opioids more frequent than elderly without. One possible explanation is that opioids may be used not only to treat pain but also behavioral symptoms.OBJECTIVE:
To test the hypothesis that strong opioid use, especially transdermal formulations, had increased, especially in elderly with dementia, in parallel with a decrease in antipsychotic use.METHODS:
Population-based cross-sectional study conducted using nationwide Danish registers with data on Denmark's entire elderly population age ≥65 (2000 nâ=â802,106; 2015 nâ=â1,056,476). The registers were used to identify elderly with and without dementia and filled prescriptions for opioids and antipsychotics. Annual prevalence of opioid and antipsychotic use from 2000-2015 was calculated.RESULTS:
Prevalence of opioid use increased by 35% (24.2 to 32.5%) among elderly with dementia and by 13% among elderly without (14.9 to 16.8%) from 2000-2015. The disproportionate increase in opioid use among elderly with dementia was mainly driven by an increase in strong opioids (dementia 11.7 to 23.1%; without dementia 5.9 to 7.4%). Use of antipsychotics decreased during the same period (dementia 31.3 to 19.3%; no dementia 4.5 to 2.7%).CONCLUSION:
From 2000-2015, use of opioids among the elderly increased with a disproportionately higher increase among elderly with dementia. The parallel decrease in the use of antipsychotics may suggest that opioids to some extent have replaced antipsychotics in managing behavioral symptoms, despite safety concerns and lack of evidence for effect of opioids. Future research should focus on potential risks associated with increased opioid use.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Antipsicóticos
/
Sintomas Comportamentais
/
Demência
/
Analgésicos Opioides
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Alzheimers Dis
Assunto da revista:
GERIATRIA
/
NEUROLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Dinamarca