Researchers of Biogipuzkoa HRI lead a study that relates the use of antipsychotics in dementia with socioeconomic status

^{Caption: Dr. Javier Mar} 

Antipsychotics are widely used in the elderly due to the high prevalence of neuropsychiatric symptoms and disruptive behaviors associated with dementia. Concern about their inappropriate use has led government reports to warn about their risks and to recommend a reduction in their use for behavioral and psychological symptoms of dementia. Disparities by socioeconomic status have also been noted in their use, and a gradient with educational level has been found in the use of antipsychotics both in the general population and in people with dementia. For a comprehensive analysis of disparities in the indication of antipsychotics, more variables such as sex, age, and somatic and psychiatric comorbidities should be taken into account.

The main findings of this Gipuzkoa population-based study (221,777 individuals over 60 years of age) were the high rates of use of antipsychotics and the greater likelihood of receiving this type of drug among people with low socioeconomic status. The percentage of antipsychotic user rose from 2.9% in high to 6.7% in low socioeconomic status and achieved 39.8% in people with dementia.  The explanation for this disparity is that atypical antipsychotics are more often the first-line response to challenging behaviors in dementia in deprived people. Meanwhile, as families are in charge of organizing home care, a higher level of income makes it possible to obtain other support to reduce the distress associated with caregiving and delay the use of antipsychotics.

The main conclusion of the study is that the greater levels of antipsychotic use and institutionalization in people of low socioeconomic indicate a lack of equity in the management of dementia-related neuropsychiatric symptoms. Increasing the offer of non-pharmacological treatments in the public health system might help reduce inequity in antipsychotic use.

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NOTES FOR EDITORS

ARTICLE

These results have been published in the article “Disease Disparities by Socioeconomic Status and Diagnosis of Dementia in the Prescribing of Antipsychotics in a Real-World Data Population Over 60 Years of Age” in the Journal of Alzheimer’s Disease. An early online version of this paper detailing the findings has been published and is scheduled for publication in the Volume (100), Issue (2), of that journal on July 16, 2024.

DOI: 10.3233/JAD-240004

Authors: Mar, Javier | Zubiagirre, Uxue | Larrañaga, Igor | Soto-Gordoa, Myriam | Mar-Barrutia, Lorea | González-Pinto, Ana | Ibarrondo, Oliver

CONTACT

Dr. Javier Mar

Ad Honorem Researcher

Economic Evaluation of Chronic Diseases

Biogipuzkoa Research Institute

Donostia-San Sebastian

Spain

Email address: javier.marmedina@gmail.com

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