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.