European Journal of Clinical Pharmacology

, Volume 72, Issue 8, pp 987–994 | Cite as

Behavioral and psychological symptoms and psychotropic drugs among people with cognitive impairment in nursing homes in 2007 and 2013

  • Maria GustafssonEmail author
  • Ulf Isaksson
  • Stig Karlsson
  • Per-Olof Sandman
  • Hugo Lövheim
Pharmacoepidemiology and Prescription



The use of psychotropic drugs to treat behavioral and psychological symptoms among people with dementia has been widely questioned because of its limited efficacy and risk of harmful side-effects. The objectives of this study was to compare the prevalence of behavioral and psychological symptoms and the use of psychotropic drug treatments among old people with cognitive impairment living in geriatric care units in 2007 and 2013.


Two questionnaire surveys were performed in 2007 and 2013, comprising all those living in geriatric care units in the county of Västerbotten in northern Sweden. A comparison was made between 1971 people from 2007 and 1511 people from 2013. Data were collected concerning psychotropic and antidementia drug use, functioning in the activities of daily living (ADL), cognition, and behavioral and psychological symptoms, using the Multi-Dimensional Dementia Assessment Scale (MDDAS).


Between 2007 and 2013, the use of antipsychotic drugs declined from 25.4 to 18.9 %, and of anxiolytic, hypnotic, and sedative drugs from 35.5 to 29.4 %. The prevalence of people prescribed antidepressant drugs remained unchanged while antidementia drug prescription increased from 17.9 to 21.5 %. When controlled for demographic changes, 36 out of 39 behavioral and psychological symptoms showed no difference in prevalence between the years.


The use of antipsychotic, anxiolytic, hypnotic, and sedative drugs declined considerably between 2007 and 2013 among old people with cognitive impairment living in geriatric care units. Despite this reduction, the prevalences of behavioral and psychological symptoms remained largely unchanged.


Dementia Nursing home Behavioral and psychological symptoms Alzheimer’s disease Psychotropic drugs Antipsychotics 



This study was supported financially by grants from the Swedish Dementia Association, County Council of Västerbotten, and Swedish Brainpower.

Description of authors’ roles

M. Gustafsson and H. Lövheim analyzed and interpreted the data and prepared the manuscript. P.O. Sandman, S. Karlsson, and U. Isaksson were responsible for the study concept, design, and acquisition of subjects. All authors carried out a critical revision of the manuscript, contributed with comments, and approved the final version.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Supplementary material

228_2016_2058_MOESM1_ESM.docx (87 kb)
ESM 1 (DOCX 86 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Maria Gustafsson
    • 1
    • 2
    Email author
  • Ulf Isaksson
    • 3
    • 4
  • Stig Karlsson
    • 3
  • Per-Olof Sandman
    • 3
    • 5
  • Hugo Lövheim
    • 2
  1. 1.Department of Pharmacology and Clinical Neuroscience, Division of Clinical PharmacologyUmeå UniversityUmeåSweden
  2. 2.Department of Community Medicine and Rehabilitation, Geriatric MedicineUmeå UniversityUmeåSweden
  3. 3.Department of NursingUmeå UniversityUmeåSweden
  4. 4.Arctic Research Centre at Umeå UniversityUmeåSweden
  5. 5.Department of Neurobiology, Care Sciences and Society, Division of NursingKarolinska InstitutetStockholmSweden

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