Peterborough City Hospital, UK
Title: Antidepressant medication use in dementia: 5-year comparison of vascular dementia and late onset Alzheimer’s disease in an acute organic psychiatric assessment unit
Yunfei Yang is a Foundation year 1 Doctor, currently based in Peterborough under the Cambridgeshire and Peterborough Foundation Trust in the UK. She has spent most of her life in the UK and recently graduated from the University of Oxford prior to taking up her FY1 training post.
Purpose: To audit the incidence of depression (antecedent, concurrent or new) through antidepressant use among clients in the old-age (age >65) acute admission wards in a single UK centre.
Background: Major depressive symptoms have been reported in ~20% of Alzheimer’s disease patients and up to 50% of vascular dementia patients. The cause-correlation between the two conditions is not fully clear.
Methods: We performed a retrospective descriptive study using the Rio electronic patient records (EPR) system. We analyzed admissions and transfers in between 2013-2018 for clients with a recorded diagnosis of late onset Alzheimer’s disease (LOAD) or vascular dementia (VD). We have recorded their physical and psychiatric comorbidities at admission, the year of dementia and depression diagnosis and tracked medication changes during the course of their inpatient stay. All statistics were performed in Microsoft excel.
Results: There were 34 clients with LOAD (47% male, 53% female) and 22 clients with VD (75% male, 25% female). We found a slightly higher incidence of depression associated with patients with VD (n=12, 61%) compared to LOAD (n=18, 56%). We also comment on the temporal relation of the depression and dementia and on specific cases of rationale for the prescription of psychotropic medication.
Conclusion: Over half of our population in both cohorts had depression prior or as a new diagnosis, which conflicts with the general literature. This is partly due to limited study numbers, the use of antidepressants for other conditions (BPSD) in particular, but also the difficulty in diagnosis and limitations of the Rio system.