Antidementia and Psychotropic Drug Use in Older People with Dementia in Australia: A National Data Linkage Study

Objectives

To estimate the national prevalence of antidementia and psychotropic medication use, and sociodemographic factors associated with their use, in Australians living with dementia.

Design

Retrospective cross-sectional study.

Setting and participants

Nationwide data linkage study using 2021 Census and Pharmaceutical Benefits Scheme (PBS) data. All people aged 65 or older with dementia (self-reported in the Census or dispensed an antidementia drug subsidized by the PBS) were included.

Methods

Medication use was defined as at least 1 dispensing during the 3-month period following the Census (August–October 2021). Prevalence of antidementia and psychotropic medication use, including antipsychotics, benzodiazepines and Z-drugs, antiepileptics, opioids, and psychostimulants, was calculated. Sociodemographic factors associated with medication use were explored using multivariable logistic regression models.

Results

Of the 177,809 older people living with dementia included, 58.6% were using at least 1 psychotropic medication. Antidepressants were the most commonly used psychotropics (41%), followed by opioids (20%) and antipsychotics (13%). Antidementia medications were used by a quarter of people with dementia (26%).

People with dementia living in the highest socioeconomic area were more likely to use antidementia medications [adjusted odds ratio (OR), 1.22; 95% CI, 1.17–1.28] and less likely to use psychotropics (OR, 0.91; 95% CI, 0.88–0.95) compared with people living in the lowest socioeconomic area. Conversely, those living in inner regional areas were more likely to use psychotropics (OR, 1.06; 95% CI, 1.03–1.10) and less likely to use antidementia medications (OR, 0.79; 95% CI, 0.77–0.82) compared with people living in metropolitan areas.

Conclusions and Implications

Psychotropics were commonly used in people with dementia in Australia. Disparities in access to health care due to socioeconomic status or remoteness may have influenced the use of antidementia and psychotropic medications. Further strategies to allow more equitable access to resources and medications are needed.