Skip to main content

Advertisement

Log in

Changes in drug treatment in the elderly between 1971 and 2000

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

To investigate changes in drug treatment among elderly men and women over a 29-year period between 1971 and 2000.

Methods

Drug consumption was investigated in five representative population samples of 70-year-olds born in 1901–1902 (n=973), 1906–1907 (n=1036), 1911–1912 (n=619), 1922 (n=449) and 1930 (n=506) and in three representative samples of 79- to 80-year-olds born in 1901–1902 (n=537), 1906–1907 (n=538) and 1915 (n=212).

Results

The proportion of 70-year-olds who used drugs increased from 60% to 79% in men and from 76% to 88% in women from 1972 to 2000. Among 80-year-olds, 21% of the men and 11% of the women were without drug treatment in 1980, compared with 7% in 1995. The average number of drugs among 70-year-olds on treatment increased during the observation period from 2.8 to 3.5 in men and from 2.8 to 4.0 in women. At age 79–80 years, the mean number of drugs was 3.3 in men and 4.0 in women in 1980 and 4.0 in men and 4.7 in women in 1995. The most common drugs were cardiovascular drugs, analgesics and drugs for diseases in the central nervous system. The most pronounced changes in the consumption of specific drugs were found for anti-ulcerative drugs (increased), digitalis (decreased), diuretics (decreased in women), anti-thrombotic drugs (increased), calcium/vitamin D (increased), insulin (increased in men aged 70 years), analgesics (increased), levaxin (increased in women), anti-depressants (increased in women aged 70 years) and oestrogen in women (increased). The treatment patterns for cardiovascular diseases changed during the observation period and the use of calcium antagonists, angiotensin converting enzyme inhibitors, β-blockers and lipid-lowering drugs increased.

Conclusion

The proportion of the population with drug treatment at ages 70 years and 79–80 years increased as did the average number of drugs among treated subjects between 1971 and 2000. Important differences in the treatment patterns for different diseases were observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Landahl S (1987) Drug treatment in 70–82-year-old persons. A longitudinal study. Acta Med Scand 221:179–184

    CAS  PubMed  Google Scholar 

  2. Barat I, Andreasen F, Damsgaard EM (2000) The consumption of drugs by 75-year-old individuals living in their own homes. Eur J Clin Pharmacol 56:501–509

    Google Scholar 

  3. Nobili A, Tettamanti M, Frattura L, Spagnoli A, Ferraro L, Marrazzo E, Ostino G, Comelli M (1997) Drug use by the elderly in Italy. Ann Pharmacother 31:416–422

    CAS  PubMed  Google Scholar 

  4. Woo J, Ho SC, Yuen YK, Lau J (1995). Drug use in an elderly Chinese population: prevalence and associated factors. Gerontology 41:98–108

    CAS  PubMed  Google Scholar 

  5. Jylha M (1994) Ten-year change in the use of medical drugs among the elderly—a longitudinal study and cohort comparison. J Clin Epidemiol 47:69–79

    CAS  PubMed  Google Scholar 

  6. Rumble RH, Morgan K (1994) Longitudinal trends in prescribing for elderly patients: two surveys four years apart. Br J Gen Pract 44:571–575

    CAS  PubMed  Google Scholar 

  7. National Board of Health and Welfare (2000) The quality of drug treatment in the elderly (Kvaliteten på läkemedelsanvändning hos äldre. Socialstyrelsen följer upp och utvärderar) Report 2000:8

  8. Raschetti R, Morgutti M, Menniti-Ippolito F, Belisari A, Rossignoli A, Longhini P, La Guidara C (1999) Suspected adverse drug events requiring emergency department visits or hospital admissions. Eur J Clin Pharmacol 54:959–963

    Article  CAS  PubMed  Google Scholar 

  9. Chan M, Nicklason F, Vial JH (2001) Adverse drug events as a cause of hospital admission in the elderly. Intern Med J 31:199–205

    Article  CAS  PubMed  Google Scholar 

  10. Hohl CM, Dankoff J, Colacone A, Afilalo M (2001) Polypharmacy, adverse drug-related events, and potential adverse drug interactions in elderly patients presenting to an emergency department. Ann Emerg Med 38:666–671

    Article  CAS  PubMed  Google Scholar 

  11. Barat I, Andreasen F, Damsgaard EM (1998) Drug therapy in the elderly: what doctors believe and patients actually do. Br J Clin Pharmacol 51:615–622

    Article  Google Scholar 

  12. Lernfelt B, Landahl S, Johansson P, Seligman L, Aberg J (1998) Haemodynamic and renal effects of felodipine in young and elderly subjects. Eur J Clin Pharmacol 54:595–601

    Article  CAS  PubMed  Google Scholar 

  13. Moore AR, O'Keeffe ST (1999) Drug-induced cognitive impairment in the elderly. Drugs Aging 15:15–28

    CAS  PubMed  Google Scholar 

  14. Flockhart D, Tanus-Santos J (2002) Implications of cytochrome P450 interactions when prescribing medication for hypertension. Arch Intern Med 162:405–412

    Article  CAS  PubMed  Google Scholar 

  15. Rinder L, Roupe S, Steen B, Svanborg A (1975) Seventy-year-old people in Gothenburg. A population study in an industrialized Swedish city. General presentation of the study. Acta Med Scand 198:397–407

    CAS  PubMed  Google Scholar 

  16. Nilsson-Ehle H, Jagenburg R, Landahl S, Svanborg A, Westin J (1988) Haematological abnormalities and reference intervals in the elderly. A cross-sectional comparative study of three population samples aged 70, 75 and 81 years. Acta Med Scand 224:595–604

    CAS  PubMed  Google Scholar 

  17. Erikson BG, Mellström D, Svanborg A (1987) A medical social intervention in a 70-year-old Swedish population. A general presentation of methodological experience. Compr Gerontol 1:49–56

    Google Scholar 

  18. Rothenberg E, Bosaeus I, Steen B (1996) Food habits and nutrient intake in three 70-year-old free-living populations in Gothenburg, Sweden. A 22-year cohort study. Scand J Nutr 40:104–110

    Google Scholar 

  19. Schroll M, Steen B, Berg S, Heikkinen E, Viidik A (1993) NORA—Nordic research on ageing. Functional capacity of 75-year-old men and women in three Nordic localities. Dan Med Bull 40:618–624

    CAS  PubMed  Google Scholar 

  20. Skoog I, Nilsson L, Palmertz B, Andreasson LA, Svanborg A (1993) A population-based study of dementia in 85-year-olds. N Engl J Med 328:153–158

    Article  CAS  PubMed  Google Scholar 

  21. Lernfelt B, Forsberg M, Blomstrand C, Mellström D, Volkmann R (2002) Cerebral atherosclerosis as a predictor for stroke and mortality in representative elderly population. Stroke 33:224–229

    Article  CAS  PubMed  Google Scholar 

  22. Ronning M, Blix HS, Harbo BT, Strom H (2000) Different versions of the anatomical therapeutic chemical classification system and the defined daily dose—are drug utilisation data comparable? Eur J Clin Pharmacol 56:723–727

    Article  PubMed  Google Scholar 

  23. Mantel N (1963) Chi-square tests with one degree of freedom: extensions of the Mantel-Haenzel procedure. J Am Stat Ass 58:690

    Google Scholar 

  24. Gause-Nilsson I, Gnarpe H, Gnarpe J, Lundborg P, Steen B (1998) Heliobacter pylori serology in elderly people: a 21-year cohort comparison in 70-year-olds and a 20-year longitudinal population study in 70–90-year-olds. Age Ageing 27:433–436

    CAS  PubMed  Google Scholar 

  25. Jönsson R, Rosenhall U, Gause-Nilsson I, Steen B (1998) Auditory function in 70- and 75-year-olds of four age cohorts. Scand Audiol 27:81–93

    Article  PubMed  Google Scholar 

  26. Selzer A (1991). Digitalis in cardiac failure. Do benefits justify risks? Arch Int Med 114:537–575

    Google Scholar 

  27. Kimmelstiel C, Benotti JR (1988) How effective is digitalis in the treatment of congestive heart failure? Am Heart J 116:1063–1069

    CAS  PubMed  Google Scholar 

  28. Remme W, Swedberg K (2001) Task force for the diagnosis and treatment of chronic heart failure, European Society of Cardiology. Eur Heart J 22:1527–1560

    Article  CAS  PubMed  Google Scholar 

  29. Cohen-Solal A, Desnos M, Delahayne F et al (2000) A national survey of heart failure in French hospitals. Eur Heart J 21:763–769

    Article  CAS  PubMed  Google Scholar 

  30. World Health Organisation and International Society of Hypertension (1999) Guidelines for the management of hypertension. J Hypertens 17:151–183

    PubMed  Google Scholar 

  31. Onder G, Gambassi G, Landi F, Pedone C, Cesari M, Carbonin PU, Bernabei R, investigators of the GIFA Study (SIGG-ONLUS) (2001) Trends in antihypertensive drugs in the elderly: the decline of thiazides. J Hum Hypertens 15:291–297

    CAS  PubMed  Google Scholar 

  32. Elliott WJ, Black HR (2002) Treatment of hypertension in the elderly. Am J Geriatr Cardiol 11:11–22

    PubMed  Google Scholar 

  33. Smith SC, Blair SN, Criqui MH et al (1995) Preventing heart attack and death in patients with coronary heart disease. Circulation 92:2–4

    PubMed  Google Scholar 

  34. Krumholz HM et al (1998) National use and effectiveness of beta blockers for the treatment of elderly patients after acute myocardial infarction. JAMA 280:623–629

    CAS  PubMed  Google Scholar 

  35. Sumerai SB, Mclaughlin TJ, Spieleman D, Hertzmark E, Thibault G, Goldman L (1997) Adverse outcomes of underuse of beta blockers in elderly survivors of acute myocardial infarction. JAMA 277:115–121

    CAS  PubMed  Google Scholar 

  36. David A, Ganz BA et al (1999) Age related differences in management of heart disease: a study of cardiac medication use in an older cohort. J Am Geriatr Soc 47:145–115

    CAS  PubMed  Google Scholar 

  37. The National Cholesterol Education Program (NCEP) (2001) Expert panel on detection, evaluation and treatment of high blood cholesterol in adults. JAMA 285:2486–2497

    PubMed  Google Scholar 

  38. Cleland JG (2002) Preventing atherosclerotic events with aspirin. BMJ 324:103–105

    Article  PubMed  Google Scholar 

  39. Katona CLE (1994) Depression in old age. Wiley Liss Inc., New York, pp 16–41

  40. Skoog I (1993) Prevalence of psychotic, depressive and anxiety syndromes in demented and nondemented 85-year-olds. Int J Geriatr Psychol 8:247–253

    Google Scholar 

  41. NIH Consensus Conference Panel (1992) Diagnosis and treatment of depression in late life. JAMA 268:1018–1022

    PubMed  Google Scholar 

  42. Larson EB, Kukull WA, Buchner D, Reifler BV (1987) Adverse drug reactions associated with global cognitive impairment in elderly persons. Ann Int Med 107:169–173

    CAS  Google Scholar 

  43. Ray WA, Griffin MR, Schaffner W, Baugh DK, Melton J (1987) Psychotropic drug use and the risk of hip fracture. N Engl J Med 316:363–369

    CAS  PubMed  Google Scholar 

  44. Ray WA, Griffin MR, Downey W (1989) Benzodiazepines of short and long elimination half life and risk of hip fracture. JAMA 262:3303–3307

    Article  CAS  PubMed  Google Scholar 

  45. Thompson TL II, Moran MG, Nies AS (1983) Psychotropic drug use in the elderly. N Engl J Med 308:134–199

    PubMed  Google Scholar 

  46. Feenstra J, Grobbee DE, Mosterd A, Stricker BH (1997) Adverse cardiovascular effects of NSAIDs in patients with congestive heart failure. Drug Saf 17:166–180

    CAS  PubMed  Google Scholar 

  47. Bergendal LA, Friberg A, Schaffrath AM et al. (1997) The clinical relevance of the interaction between carbamazepine and dextropropoxyphene in elderly patients in Gothenburg, Sweden. Eur J Clin Pharmacol 53:203–206

    Article  CAS  PubMed  Google Scholar 

  48. Chapuy MC, Arlot ME, Delmas PD, Meunier PJ (1994) Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ 308:1081–1082

    CAS  PubMed  Google Scholar 

  49. Chapuy MC, Arlot ME, Duboeuf F et al (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327:1637–1642

    CAS  PubMed  Google Scholar 

  50. Dawson-Hughes B, Harris SS, Krall EA et al (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65-years of age or older. N Engl J Med 337:670–677

    Google Scholar 

  51. World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO technical report series 84

  52. Bytzer P, Talley NJ (2001) Current indications for acid suppressants in dyspepsia. Baillieres Best Pract Res Clin Gastroenterol 15:385–400

    Article  CAS  Google Scholar 

  53. Martin RM, Lim AG, Kerry SM, Hilton SR (1998) Trends in prescribing H2-receptor antagonists and proton pump inhibitors in primary care. Aliment Pharmacol Ther 12:797–805

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by grants from the Swedish Medical Research Council, the Delegation for Social Research within the Ministry of Health and Social Affairs, The Swedish Research Council (no. 11267), Swedish Council for Working Life and Social Research (no. 2835 and no. 2646), The Alzheimer's Association Stephanie B. Overstreet Scholars (IIRG-00–2159), The Gothenburg Medical Services Administration, the Gothenburg Administration of Social Services, Medical Faculty University of Gothenburg, the Wilhelm and Martina Lundgren Foundation and the Hjalmar Svensson Foundation. Our thanks to Valter Sundh for valuable statistical advice.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Landahl.

Additional information

From the gerontological and geriatric population studies in Gothenburg, Sweden. Project leader: before 1988 Professor Alvar Svanborg, from 1988 Professor Bertil Steen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lernfelt, B., Samuelsson, O., Skoog, I. et al. Changes in drug treatment in the elderly between 1971 and 2000. Eur J Clin Pharmacol 59, 637–644 (2003). https://doi.org/10.1007/s00228-003-0647-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-003-0647-6

Keywords

Navigation