Psychotropic prescription use by community-dwelling elderly in the United States

OBJECTIVES: To examine psychotropic prescription use in community-dwelling elderly in the United States and its association with predisposing, enabling, and need factors. DESIGN: Retrospective analysis of the 1996 Medical Expenditure Survey (MEPS). SETTING: A national representative sample survey of the United States non-institutionalized population. PARTICIPANTS: Community-dwelling persons aged 65 and older participating in the MEPS. MEASUREMENTS: Psychotropic prescription use patterns and factors associated with the use of psychotropics in general as well as of individual classes, specifically antidepressants, antianxiety agents, and sedative/hypnotics. RESULTS: According to the MEPS, more than 6 million (19% ) community-dwelling elderly persons used psychotropic medications in 1996. Nearly 3 million (9.1%) elderly were taking antidepressants, almost 2.5 million (7.5%) antianxiety agents, and 1.5 million (4.8%) sedative/hypnotics. Several correlates of psychotropic prescription use were identified. Enabling (e.g., prescription insurance) and need (e.g., health status) factors were found to be consistently associated with the use of antidepressant, antianxiety, and sedative/hypnotic agents. Predisposing factors such as sex, race, region, and education varied with the type of psychotropic drug class examined. CONCLUSION: Nearly one in five community-dwelling elderly persons used psychotropic medications, primarily antidepressants followed by antianxiety agents. Enabling and need factors were consistently associated with psychotropic classes examined, whereas most predisposing factors varied with the type of psychotropic drug class.