Perceived anxiety, depression, and sleeping problems in relation to psychotropic drug use among elderly in assisted-living facilities.

Objective: The aim of the present study was to
investigate the perceived anxiety, depression, sleeping
habits, and participation in social activities in relation to
psychotropic drug use among elderly in assisted-living
facilities and to identify factors of importance for the use
of these drugs.
Method: The study had a cross-sectional design and included
93 residents living in old-age homes or in nursing
homes in a municipality in southern Sweden. Data
regarding medication was obtained from medical records
and included all psychoactive drugs. The perceived
anxiety, depression and sleeping habits of the residents
were assessed using a structured interview questionnaire.
Results: Many of the residents had sleeping problems
and also reported problems concerning anxiety and
depression. Of the study population, 65 (70%) used one
or more psychoactive drug; 9 were prescribed neuroleptics
(10%), 29 anxiolytics (31%), 43 hypnotics (43%)
and 31 were prescribed anti-depressants (33%). The
most commonly used psychotropic drugs as it related to
the residents’ problems were: benzodiazepines (oxazepam)
against anxiety, benzodiazepine-related agents
(zoldipem and zopiclon) against insomnia and serotonin
reuptake inhibitors (SSRI; citalopram) against depression.
The residents who had been treated with psychotropic
drugs at home continued this treatment after
moving to assisted-living facilities and approximately
30% of the residents were prescribed new psychotropic
drugs. Of those that perceived anxiety, insomnia or felt
depressed, between 58% and 69%, respectively, had
spoken to neither a nurse nor a physician about these
problems. Of those that had talked to a nurse/physician
about these problems, a majority had been prescribed
psychotropic drugs. Factors of importance for treatment
with psychotropic drugs against anxiety, insomnia and
depression were: prior treatment with these drugs at
home and discussing their problems with a physician.
Conclusion: The communication between the residents
and the nurses/physicians appears to be insufficient as
the residents state that they have not discussed their
problems with a nurse or a physician and that the prescription
of psychotropic drugs does not seem to be in
proportion to the residents’ perceived problems.