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Sedative use by older adults with dementia is higher among women than men and exceeds recommendations
Author(s) -
Trenaman Shanna Claire,
Bowles Susan K,
Kirkland Susan,
Andrew Melissa K
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.041463
Subject(s) - sedative , medicine , dementia , sedative/hypnotic , cohort , medical prescription , galantamine , psychiatry , donepezil , pharmacology , disease
Background Sedative medications (benzodiazepines and Z‐drugs) are used to treat responsive behaviours in those with dementia despite association with adverse drug events and accepted status as potentially inappropriate medications. The objective of this study was to complete a sex‐based analysis of sedative use in a cohort of older adults with dementia in Nova Scotia, Canada. Method We examined sedative use in a cohort of adults aged 65 years and older with dementia in Nova Scotia, Canada. Prescription data was examined from April 1, 2010 to March 31, 2015. Concordance with prescribing guidelines was compared for men and women using descriptive statistics and unadjusted odds ratios. Result Of the 30,703 older adults with dementia in the cohort 11,647 (37.9%) received at least one prescription for a sedative. Women were more likely to receive a benzodiazepine (OR 1.44; 95% CI [1.36‐1.53]) or a Z‐drug (OR 1.10; 95% CI [1.01‐1.19]). Lorazepam was the most commonly prescribed sedative (52% of sedative users). Zopiclone was the second most commonly prescribed (27% of sedative users). Sedative use (37.9% of cohort) which is potentially inappropriate was almost two times greater than cholinesterase inhibitor use (19.3% of cohort) which is potentially appropriate for older adults with dementia. Conclusion Among older adults with dementia, sedatives are more commonly prescribed than cholinesterase inhibitors. Sedatives are more often used by women, suggesting that targeted interventions toward reducing sedative use in women is needed. This pattern of sedative use is not in accordance with prescribing guidelines for older adults with dementia.