Change in sedative burden after dementia onset using difference-in-difference estimations.

Area of Science:

• Gerontology
• Pharmacology
• Neurology

Background:

• Sedative agents pose risks for older adults, including cognitive decline and falls.
• Previous research has not extensively studied long-term sedative use across dementia diagnosis periods.

Purpose of the Study:

• To analyze longitudinal changes in sedative medication use before and after dementia diagnosis over a decade.
• To compare sedative use patterns in dementia patients with those without dementia.

Main Methods:

• Retrospective cohort study utilizing longitudinal health insurance claims data.
• Inclusion of 54,165 older adults (≥60 years) with 1:4 propensity score matching.
• Calculation of yearly average daily sedative load (adSL) and medication use (DDD/1000 patient-days) using difference-in-difference analysis.

Main Results:

• Patients with dementia exhibited consistently high sedative burden, which significantly increased post-diagnosis (DID 0.123 unit/day).
• Antidepressants, Z-drugs, and antipsychotics showed the most significant increases in use post-diagnosis.
• Atypical antipsychotic and antidepressant usage saw a steep rise after dementia diagnosis.

Conclusions:

• Sedative burden is elevated in dementia patients both before and after diagnosis.
• Dementia diagnosis is associated with a further increase in sedative medication burden.