Use of existing data sources in clinical epidemiology: Finnish health care registers in Alzheimer&amp;rsquo;s disease research &amp;ndash; the Medication use among persons with Alzheimer&amp;rsquo;s disease (MEDALZ-2005) study

Tolppanen, Anna‐Maija; Taipale, Heidi; Koponen, Marjaana; Lavikainen, Piia; Tanskanen, Antti; Tiihonen, Jari; Hartikainen, Sirpa

doi:10.2147/clep.s46622

Cited by 45 publications

(37 citation statements)

References 39 publications

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“…The MEDALZ-2005 cohort consists of all communitydwelling individuals with a verified diagnosis of AD residing in Finland and alive on 31 December 2005 (Tolppanen et al, 2013). One comparison individual matched for age ( 1 year), sex, and region of residence, without AD, was identified for each patient with AD from the registers of the Social Insurance Institution of Finland including all residents.…”

Section: Methodsmentioning

confidence: 99%

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Long-term use of benzodiazepines and related drugs among community-dwelling individuals with and without Alzheimer’s disease

Taipale¹,

Koponen²,

Tanskanen

et al. 2015

International Clinical Psychopharmacology

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The aim of this study was to investigate the prevalence of benzodiazepine and related drug (BZDR) use, especially long-term use, and associated factors among community-dwelling individuals with and without Alzheimer's disease (AD). We utilized data from the MEDALZ-2005 cohort, which includes all community-dwelling individuals diagnosed with AD in Finland at the end of 2005 and matched comparison individuals without AD. Register-based data included prescription drug purchases, comorbidities, and hospital discharge diagnoses. In this study, 24,966 individuals with AD and 24,985 individuals without AD were included. During the 4-year follow-up, we found that 45% (N = 11,312) of individuals with AD and 38% (N = 9534) of individuals without AD used BZDRs. The prevalence of long-term (≥ 180 days) BZDR use was more common among individuals with AD (30%) than individuals without AD (26%). The median durations of the first long-term use periods of BZDRs were 1.5 and 2 years for individuals with and without AD, respectively. Factors associated with long-term BZDR use included female sex, AD, schizophrenia, bipolar disorder, depression, coronary artery disease, and asthma/chronic obstructive pulmonary disease. The high prevalence of long-term BZDR use among individuals with AD is especially a cause for concern because long-term use may further impair cognition and may be associated with serious adverse events.

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Section: Methodsmentioning

confidence: 99%

“…Patients with all stages of AD are included in the cohort and the followup duration was 2006-2009. The MEDALZ-2005 cohort and registers are described in more detail by Tolppanen et al (2013).…”

Section: Methodsmentioning

confidence: 99%

Long-term use of benzodiazepines and related drugs among community-dwelling individuals with and without Alzheimer’s disease

Taipale¹,

Koponen²,

Tanskanen

et al. 2015

International Clinical Psychopharmacology

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“…Identification of AD cases and registers is described in more detail in Tolppanen et al (2013). In short, the Finnish Current Care Guideline recommends that all persons with AD are treated with antidementia drugs unless there is a contraindication for the use (Finnish Medical Society Duodecim, 2010).…”

Section: Methodsmentioning

confidence: 99%

High prevalence of psychotropic drug use among persons with and without Alzheimer׳s disease in Finnish nationwide cohort

Taipale

Koponen

Tanskanen

et al. 2014

European Neuropsychopharmacology

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Psychotropic drugs are used for treatment of behavioral and psychological symptoms of dementia (BPSD) although they are associated with serious adverse drug events. Objective of our study was to investigate prevalence of psychotropic drug use one year after diagnoses of Alzheimer's disease (AD), to compare prevalence to persons without AD and to assess changes in prevalence over time. Data from the MEDALZ (Medication use and Alzheimer's disease) cohort was utilized in the study including all 69,080 community-dwelling persons with new diagnosis of AD during years 2005-2011 in Finland. Four age-, gender- and region of residence-matched persons without AD were identified for each case. Register-based data included prescription drug purchases and comorbidities from Special Reimbursement Register. Annual prevalence of psychotropic drug use one year after diagnosis was determined for each person. Psychotropic drugs were used by 53% of persons with AD compared with 33% of persons without AD during one year after diagnoses. Persons with AD were six times more likely to use antipsychotics and three times more likely to use antidepressants whereas benzodiazepine and related drug (BZDR) use was comparable between persons with and without AD. According to year of AD diagnoses during 2005-2011, antipsychotic use increased from 18% to 20% (p<0.0001) and BZDR use declined from 31% to 26% (p<0.0001) among persons with AD. Widespread utilization of psychotropic drugs was observed among persons with AD. Despite safety warnings of antipsychotic use for BPSD, antipsychotic use increased from 2005 to 2011 among newly diagnosed persons with AD in Finland.

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“…(24) This is a nested case-control study of the population of Finland, including all AD cases with clinically verified diagnosis (n=28,093) and their age-, sex-, and region of residence matched controls (n of matched case-control pairs=28,093). To be included in the study sample, the participants had to be alive on December 31, 2005, and community-dwelling.…”

Section: Study Populationmentioning

confidence: 99%

Hospital-treated mental and behavioral disorders and risk of Alzheimer's disease: A nationwide nested case-control study

et al. 2017

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ArtikkelitTerveystieteiden Conflicts of Interest and Source of FundingVesa Tapiainen, Sirpa Hartikainen, Heidi Taipale and Anna-Maija Tolppanen report no competing interests. Jari Tiihonen reports serving as a consultant to AstraZeneca, Bristol-Myers Squibb, Eli Lilly, F. Hoffman-La Roche, Janssen-Cilag, Lundbeck, and Organon. He has received fees for giving expert opinions to AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck, Otsuka and Pfizer, and lecture fees from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck, Novartis, Otsuka, and Pfizer; and grant from Stanley Foundation and Sigrid Jusélius Foundation. He is a member of advisory board in AstraZeneca, Eli Lilly, Janssen-Cilag, and Otsuka.This work was supported by European Regional Development Fund (Regional Council of Pohjois-Savo) [32198 to Vesa Tapiainen, Heidi Taipale and Anna-Maija Tolppanen]. The funder had no role in study design; in the collection, analysis, and interpretation of data, in the writing of the report; and in the decision to submit the paper for publication. Conclusions:The associations between mental and behavioral disorders and AD were modest and dependent on the time window. Therefore, some of the disorders may represent misdiagnosed prodromal symptoms of AD which underlines the importance of proper differential diagnostics among older persons. These findings also highlight the importance of appropriate time window in psychiatric and neuroepidemiology research.

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Use of existing data sources in clinical epidemiology: Finnish health care registers in Alzheimer’s disease research – the Medication use among persons with Alzheimer’s disease (MEDALZ-2005) study

Cited by 45 publications

References 39 publications

Long-term use of benzodiazepines and related drugs among community-dwelling individuals with and without Alzheimer’s disease

Long-term use of benzodiazepines and related drugs among community-dwelling individuals with and without Alzheimer’s disease

High prevalence of psychotropic drug use among persons with and without Alzheimer׳s disease in Finnish nationwide cohort

Hospital-treated mental and behavioral disorders and risk of Alzheimer's disease: A nationwide nested case-control study

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