PDF(Pubmed)
Abstract：
UNASSIGNED: Antipsychotics are widely used in the elderly due to the high prevalence of neuropsychiatric associated with dementia.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
摘要：
■由于与痴呆相关的神经精神病的高患病率,抗精神病药广泛用于老年人。
通过调整躯体和精神合并症的社会经济地位（SES）和阿尔茨海默病和相关痴呆（ADRD）的诊断，分析吉普兹科亚普通人群抗精神病药使用的潜在差异。年龄,和性爱。
■对所有221,777名60岁以上的个体进行了回顾性观察研究（Gipuzkoa，西班牙）收集ADRD的诊断，Charlson合并症指数,和精神病合并症，考虑到所有的主要疾病，门诊病人,急诊和住院护理事件以及第一代和第二代抗精神病药物，和社会人口统计学变量，即,年龄,性别,SES和住在疗养院。采用Logistic回归进行多因素统计分析。
■任何抗精神病药物的使用在女性中更多，80岁以上的人，住在疗养院,诊断为痴呆症，躯体和精神合并症，低SES。喹硫平是最常用的药物。使用任何抗精神病药物的可能性与低SES显着相关（比值比[OR]：1.60；置信区间[CI]：1.52-1.68），年龄超过80岁（OR：1.56；CI：1.47-1.65），制度化（OR：12.61；CI：11.64-13.65），痴呆的诊断(OR:10.18;CI:9.55-10.85)和抑郁症的合并症(OR:3.79;CI:3.58-4.01)和精神病(OR:4.96;CI:4.64-5.30)。
■在低SES患者中，抗精神病药物的使用和机构化水平较高，表明神经精神症状的管理不公平。在卫生系统中增加非药物治疗的提供可能有助于减少不平等。
通过调整躯体和精神合并症的社会经济地位（SES）和阿尔茨海默病和相关痴呆（ADRD）的诊断，分析吉普兹科亚普通人群抗精神病药使用的潜在差异。年龄,和性爱。
■对所有221,777名60岁以上的个体进行了回顾性观察研究（Gipuzkoa，西班牙）收集ADRD的诊断，Charlson合并症指数,和精神病合并症，考虑到所有的主要疾病，门诊病人,急诊和住院护理事件以及第一代和第二代抗精神病药物，和社会人口统计学变量，即,年龄,性别,SES和住在疗养院。采用Logistic回归进行多因素统计分析。
■任何抗精神病药物的使用在女性中更多，80岁以上的人，住在疗养院,诊断为痴呆症，躯体和精神合并症，低SES。喹硫平是最常用的药物。使用任何抗精神病药物的可能性与低SES显着相关（比值比[OR]：1.60；置信区间[CI]：1.52-1.68），年龄超过80岁（OR：1.56；CI：1.47-1.65），制度化（OR：12.61；CI：11.64-13.65），痴呆的诊断(OR:10.18;CI:9.55-10.85)和抑郁症的合并症(OR:3.79;CI:3.58-4.01)和精神病(OR:4.96;CI:4.64-5.30)。
■在低SES患者中，抗精神病药物的使用和机构化水平较高，表明神经精神症状的管理不公平。在卫生系统中增加非药物治疗的提供可能有助于减少不平等。
