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Age and Ageing Advance Access originally published online on May 30, 2007
Age and Ageing 2007 36(4):449-454; doi:10.1093/ageing/afm056
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Copyright © The Author 2007. Published by Oxford University Press on behalf of the British Geriatrics Society.

Increased use of antidepressants at the end of life: population-based study among people aged 65 years and above

Dorte Gilså Hansen1, Jens-Ulrik Rosholm2, Anthony Gichangi3 and Werner Vach4

1 Research Unit for General Practice, University of Southern Denmark, JB Winsløws Vej 9A, DK-5000 Odense C, Denmark
2 Department of Geriatrics, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
3 Research Unit for General Practice, University of Southern Denmark, JB Winsløws Vej 9A, DK-5000 Odense C, Denmark
4 Department of Statistics, University of Southern Denmark, JB Winsløws Vej 9B, DK-5000 Odense C, Denmark

Address correspondence to: Dorte Gilså Hansen. Email: dgilsaa{at}health.sdu.dk

Background: the new antidepressants are generally effective and safe for older people, but may have serious side-effects. The use has been rapidly increasing, but focus on upper age groups has been limited. The pattern of antidepressant use as death approaches has never been analysed.

Objective: to analyse the use of antidepressants among individuals aged 65 years and above with respect to time trends, age and proximity to death.

Design: population-based prescription study.

Setting: the County of Funen, Denmark, 1992–2004 (~470.000 inhabitants).

Results: the 1-year prevalence of antidepressants increases steadily over time in all age groups. Among the 65+ year-olds it also increases with age and differs substantially between the youngest and the oldest. Very high prevalences are observed: 26.8% among females 85–89 years old and 17.5% among males 85 years and above in 2004. In all age groups the use of antidepressants increases substantially with proximity to death in the last 3 years of life. In the last phase of life the use is independent of whether the patient dies at age 65 or 90 about 33% of females and 25% of males receive antidepressants in the last 6 months.

Conclusions: the use of antidepressants among 65+ year-olds increases with age and proximity to death to very high levels. Future studies may clarify the problems and diagnoses giving rise to the use of antidepressants for such a large proportion of older people, and especially the problems giving rise to treatment as death approaches.

Keywords: antidepressive agents, drug prescriptions, aged, death, pharmacoepidemiology, elderly

Received 21 November 2006; accepted in revised form 18 April 2007.


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