Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 5

ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS I
ABSTRACTS
N - NAPE
N-1 Wednesday 13/8,10:10-10:30
The association between age and depression in the
general population: a multivariate examination
Eyslein Stnrdal MD, Helse Nord-Tr0ndelag HF, Hospilal Namsos, Department of
Psychiatry, N-7800 Namsos, Norway. Arnstein Mykletun MA, Alv A. Dahl MD. PhD.
Eystein.stordal@hu.no
Background: In a large general population study we found a close
to linear rise with age in the mean score and prevalence of self-
reported symptoms of depression.
Aims: To examine if this linear relation prevailed when controlled
for multiple variables, and to examine what factors that eventually
explained the association.
Metliod: Among individuals aged 20-89 years living in Nord-
Trpndelag County of Norway, 60869 l'illed in valid ratings of the
Hospital Anxiety and Depression Scale (HADS) as well as ntany
other variables. Covariates were grouped into a multivariate model
with six blocks. Logistic regression was used to model the blocks
and variables with caseness of depression as the dependent
variable.
Results: The ntodel explains a considerable part of the age-related
pattern on depression. Tlie pattern becante less distinct in the age
groups above 50 years. Variables within the blocks of somatic
diagnoses and symptoms, as well as impairment, had most explana-
tory power. Four blocks reduce the prevalence of depression signi-
ficantly: Impairment, sociodemographics, somatic diagnosis and
somatic symptoms. Eight single variables reduce the age-effect:
Education, impairment caused by movement, hearing, vision and
physical disease, physical activity, muscle skeletal disorders, and
muscle skeletal symptoms.
Conclusions: Due to our large sample we were able to control for
more relevant variables than earlier studies. In contrast to most
other studies, we found that an age-related increase of the preva-
lence of depression persisted after control for multiple variables.
N - 2 Wednesday 13/8,10:30-10:50
Epidemiology of old age in lceland
1 lull^ríniiir Magnússon. tlr med, Head of Department. Dept. of Psychiatry of Old Age,
Ullevál University Hospital, Slottsbergen 35,1385 Asker, Norway
hillgrimur@oslo.onlme.no
Introduction: In Iceland a longitudinal epidentiological study of a
birth cohort has been carried out. Tlte study covers almost the
whole lifespan of every Icelander born in three consecutive years.
The study based its case finding and diagnosis on extensive inter-
views with the general practitioners in the country and on thorough
review of medical records. This strategy was timely when it first
appeared but in the Iast phase of the study it was supplemented
with interviews of the subjects themselves using the Geriatric
Mental State Schedule.
Results: The prevalence of depression in Iceland was 7,9% and
8,7% al the age of 81 and 87 years respectively. Compared to similar
studies in Europe, Iceland has the lowest prevalence. Iceland also
has very low suicidal rate in old age compared to other countries.
Pattern of depressive symptoms in the general population in
Iceland differed considerably from similar data in other countries in
Europe.
Tlte prevalence of dementia in Iceland was 7,8 and 15,1 at the
age of 81 and 87 years respectively. Several recent studies on the
incidence rate of dementia show results similar to the Icelandic
study.
N - 3 Wednesday 13/8,11:10-11:30
Psychotropic use in the homedwelling elderly
Sirpa Hartikainen. Clinical Lecturer, Kuopio University, Division of Geriatrics, Depart-
ment of Public Health and General Practise, Finland
sirpa. hartikainen @uku.fi
Psychotropic use is common and becoming even more common
among the elderly in Finland. This use includes lots of adverse
effects, especially falls and cognition. Risks of interactions grow
when using with several other medicines.
The Kuopio 75+ Study is a population based health survey
focused on epidemiology of medicine use and functional capacity
among the elderly subjects aged 75 years or older. A random
sample of 700 subjects was drawn from a total population aged at
lcast 75 years and living in the city of Kuopio on January 1, 1998
(n=4518). A structured clinical examination and interview were
carried out for 601 subjects (86% out of random sample) by a
geriatrician and a trained nurse. Those living in institutions (n=78)
were excluded; thus, 523 persons were subjects in this study.
At least one psychotropic medicine was used by 37% of the
elderly and 12% were using at least two psychotropics concomit-
antly. Those using psychiatric medication were older, more often
widowed, and living alone than non-users. The probability of
psychotropic use increased linearly with age for anxiolytics/
hypnotics and for antipsychotics, but nol for antidepressants.
Anxiolytics and hypnotics were most commonly prescribed
psychotropic medicine (30%) and one-tenth was using antidepres-
sant (11%) or antipsychotic medicine (9%).
The demented person more often uses all kinds of psychotropic
medicines than non-demented. One of four demented elderly com-
pared to one in ten non-demented used at least two psychotropics.
The demented elderly used antipsychotics six times more often
than the non-demented and tended to use antidepressants more
commonly as well.
Among the non-demented elderly, one out of every two anti-
psychotics (N=31) users was suffering from depression according to
DSM IV criteria. However, at the same time most non-demented
depressed persons (N=79, 68%) were not receiving any anlide-
pressant medication.
Condusion: Prescription practice that most commonly gives
psychotropic medication to the oldest and most vulnerable ones
includes high risks of adverse effects and interactions. It seems thal
the threshold to prescribe antipsychotics to the elderly is low. The
Læknablaðið / FYLGIRIT 4S 2003/89 5