Clinical profile of trazodone users in a multisetting older population: data from the Italian GeroCovid Observational study
Aim To comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants in a large dataset from the GeroCovid Observational multiscope and multisetting study. Findings 10.8% out of 3396 persons included used trazodone and the 8.5% other antidepressants; the use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to long-term care facilities or living at home. Conditions associated with trazodone use included depression, dementia and behavioral and psychological symptoms of dementia. Message The present data suggest an off-label use of trazodone as a possible therapeutic option in the challenging field of behavioral and psychological disturbances in older adults with dementia..
Background and objectives Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim of the study is to comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants. Methods This cross-sectional study involved adults aged ≥ 60 years at risk of or affected with COVID-19 enrolled in the GeroCovid Observational study from acute wards, geriatric and dementia-specific outpatient clinics, as well as long-term care facilities (LTCF). Participants were grouped according to the use of trazodone, other antidepressants, or no antidepressant use. Results Of the 3396 study participants (mean age 80.6 ± 9.1 years; 57.1% females), 10.8% used trazodone and 8.5% others antidepressants. Individuals treated with trazodone were older, more functionally dependent, and had a higher prevalence of dementia and BPSD than those using other antidepressants or no antidepressant use. Logistic regression analyses found that the presence of BPSD was associated with trazodone use (odds ratio (OR) 28.4, 95% confidence interval (CI) 18-44.7 for the outcome trazodone vs no antidepressants use, among participants without depression; OR 2.17, 95% CI 1.05-4.49 for the outcome trazodone vs no antidepressants use, among participants with depression). A cluster analysis of trazodone use identified three clusters: cluster 1 included mainly women, living at home with assistance, multimorbidity, dementia, BPSD, and depression; cluster 2 included mainly institutionalized women, with disabilities, depression, and dementia; cluster 3 included mostly men, often living at home unassisted, with better mobility performance, fewer chronic diseases, dementia, BPSD, and depression. Discussion The use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to LTCF or living at home. Clinical conditions associated with its prescription included depression as well as BPSD..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
European geriatric medicine - 14(2023), 3 vom: 19. Mai, Seite 465-476 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Coin, Alessandra [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
BPSD, Profile, Clinical characteristics |
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| Anmerkungen: |
© The Author(s), under exclusive licence to European Geriatric Medicine Society 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s41999-023-00790-1 |
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| funding: |
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| 520 | |a Aim To comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants in a large dataset from the GeroCovid Observational multiscope and multisetting study. Findings 10.8% out of 3396 persons included used trazodone and the 8.5% other antidepressants; the use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to long-term care facilities or living at home. Conditions associated with trazodone use included depression, dementia and behavioral and psychological symptoms of dementia. Message The present data suggest an off-label use of trazodone as a possible therapeutic option in the challenging field of behavioral and psychological disturbances in older adults with dementia. | ||
| 520 | |a Background and objectives Depression is highly prevalent in older adults, especially in those with dementia. Trazodone, an antidepressant, has shown to be effective in older patients with moderate anxiolytic and hypnotic activity; and a common off-label use is rising for managing behavioral and psychological symptoms of dementia (BPSD). The aim of the study is to comparatively assess the clinical profiles of older patients treated with trazodone or other antidepressants. Methods This cross-sectional study involved adults aged ≥ 60 years at risk of or affected with COVID-19 enrolled in the GeroCovid Observational study from acute wards, geriatric and dementia-specific outpatient clinics, as well as long-term care facilities (LTCF). Participants were grouped according to the use of trazodone, other antidepressants, or no antidepressant use. Results Of the 3396 study participants (mean age 80.6 ± 9.1 years; 57.1% females), 10.8% used trazodone and 8.5% others antidepressants. Individuals treated with trazodone were older, more functionally dependent, and had a higher prevalence of dementia and BPSD than those using other antidepressants or no antidepressant use. Logistic regression analyses found that the presence of BPSD was associated with trazodone use (odds ratio (OR) 28.4, 95% confidence interval (CI) 18-44.7 for the outcome trazodone vs no antidepressants use, among participants without depression; OR 2.17, 95% CI 1.05-4.49 for the outcome trazodone vs no antidepressants use, among participants with depression). A cluster analysis of trazodone use identified three clusters: cluster 1 included mainly women, living at home with assistance, multimorbidity, dementia, BPSD, and depression; cluster 2 included mainly institutionalized women, with disabilities, depression, and dementia; cluster 3 included mostly men, often living at home unassisted, with better mobility performance, fewer chronic diseases, dementia, BPSD, and depression. Discussion The use of trazodone was highly prevalent in functionally dependent and comorbid older adults admitted to LTCF or living at home. Clinical conditions associated with its prescription included depression as well as BPSD. | ||
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| 700 | 1 | |a Fini, Filippo |4 aut | |
| 700 | 1 | |a Abbatecola, Angela Marie |4 aut | |
| 700 | 1 | |a Del Signore, Stefania |4 aut | |
| 700 | 1 | |a Malara, Alba |4 aut | |
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| 700 | 1 | |a Bellelli, Giuseppe |4 aut | |
| 700 | 1 | |a Zia, Gianluca |4 aut | |
| 700 | 1 | |a Incalzi, Raffaele Antonelli |4 aut | |
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