Drug use among the home-dwelling elderly: Trends, polypharmacy, and sedation
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4.2. Study protocol

In addition to the question of prescription drug use during one week prior to the interview, the questionnaires included items asked or measured by one of two trained nurses on

sociodemographic and other backgroud data
physical, psychic, and social functional abilities
smoking, alcohol consumption (the latter in 1998–99)
tests and measurements: several laboratory examinations, x-trays, physical/physiological measurements
quality of life (in 1998–99 self-perceived health and life satisfaction), home nursing services
two health center physicians who belonged to the research team conducted the clinical examinations of the participants

The connections of depression and dementia with drug use were not analyzed in this study. Both diseases are multifactorial, and their connections with drug use would warrant another study. Nor were the associations of single diagnoses with drug use analyzed, because the basic approach of this study was pharmacoepidemiological rather than clinical. Instead, in the latter survey, the diseases recorded by Social Insurance Institution as entitling the patient to a special refund of medication costs were counted.

4.2.1. Ethics

The study was conducted according to the guidelines of the Declaration of Helsinki, and the Ethics Committee of Turku University and Turku University Central Hospital. All subjects gave written informed consent.

Table 3a. Sociodemographic and other characteristics of the home-dwelling elderly by the number of drugs used in community in 1990–91 and 1998–99.

Characteristics of persons	Number of drugs								Significance^c
	0		1–5		> 5		Total		Significance^c
	1990–91	1998–99	1990–91	1998–99	1990–91	1998–99	1990– 91	1998– 99	1990–91	1998–99
	n = 252	n = 141	n = 659	n = 756	n = 220	n = 300	n = 1131	n = 1197
	%	%	%	%	%	%	%	%
Age in years									< 0.0001	< 0.0001
64–74	80	82	64	69	48	51	65	66
75–84	19	16	30	27	46	36	31	23
> 84	2	1	6	5	6	13	5	7
Mean age in years^a	70	70	73	73	75	75	73	73	<0.0001	< 0.0001
Gender									< 0.05	< 0.05
Men	49	65	42	42	32	35	41	43
Women	51	35	58	58	68	65	59	57
Marital status									< 0.001	< 0.01
Married/ cohabiting	68	72	58	61	45	55	58	61
Widowed	20	13	32	28	47	38	32	29
Other	9	11	10	11	8	7	8	7
Living alone	23	18	34	31	40	35	33	31	ns	ns
Poor self-perceived health status^b	–	2	–	10	–	31	–	14	–	< 0.0001
Poor life satisfaction^b	–	1	–	3	–	6	–	3	–	< 0.01
Home nursing services	0	0	3	4	16	13	5	6	< 0.0001	< 0.0001
^aAll the results are presented as percentages except mean age. ^bThese items were asked only in 1998–99. ^cStatistical tests were made only between persons with 1 to 5 and > 5 drugs separately in 1990–91 and 1998–99. Categorial variables were tested with Chi-square test, and continuous variables with Student`s t-test. ns = no statistical significance.

Table 3b. Sociodemographic and other characteristics of home-dwelling elderly men by the number of drugs used in community in 1990–91 and 1998–99.

Characteristics of persons	Number of drugs								Significance^c
	0		1–5		> 5		Total		Significance^c
	1990–91	1998–99	1990–91	1998–99	1990–91	1998–99	1990–91	1998– 99	1990–91	1998–99
	n = 123	n = 92	n = 275	n = 321	n = 71	n = 105	n = 469	n = 518
	%	%	%	%	%	%	%	%
Age in years									< 0.05	< 0.01
64–74	81	82	65	72	58	55	68	70
75–84	18	17	30	23	42	36	29	25
> 84	1	1	5	5	0	9	3	5
Mean age in years^a	70	70	72	72	74	75	72	72	ns	< 0.001
Marital status									ns	ns
Married/ cohabiting	83	77	77	79	70	75	78	78
Widowed	9	8	15	14	24	14	15	13
Other	8	15	8	7	6	10	8	9
Living alone	13	14	22	19	20	17	19	18	ns	ns
Poor self-perceived health status^b	–	3	–	12	–	34	–	15	–	< 0.0001
Poor life satisfaction^b	–	1	–	2	–	7	–	3	–	< 0.05
Home nursing services	0	0	4	3	17	9	5	3	< 0.0001	< 0.01
^aAll the results are presented as percentages except mean age. ^bThese items were asked only in 1998–99. ^cStatistical tests were made only between persons with 1 to 5 and > 5 drugs separately in 1990–91 and 1998–99. Categorial variables were tested with Chi-square test, and continuous variables with Student`s t-test. ns = no statistical significance.

Table 3c. Sociodemographic and other characteristics of home-dwelling elderly women by the number of drugs used in community in 1990–91 and 1998–99.

Characteristics of persons	Number of drugs								Significance^c
	0		1–5		> 5		Total		Significance^c
	1990–1991	1998–99	1990–91	1998–99	1990–91	1998–99	1990–91	1998–99	1990–91	1998–99
	n = 129	n = 49	n = 384	n = 435	n = 149	n = 195	n = 662	n = 679
	%	%	%	%	%	%	%	%
Age in years									< 0.0001	< 0.0001
64–74	78	84	64	66	43	48	62	62
75–84	19	14	29	29	48	36	32	30
> 84	2	2	7	5	9	16	6	8
Mean age in years^a	70	71	73	73	76	76	73	73	< 0.0001	< 0.0001
Marital status									< 0.05	< 0.01
Married/ cohabiting	53	61	45	48	33	44	44	48
Widowed	30	24	44	39	58	50	45	41
Other	16	14	11	14	9	6	11	11
Living alone	32	27	43	40	49	45	42	41	ns	ns
Poor self-perceived health status^b	–	0	–	8	–	29	–	14	–	< 0.0001
Poor life satisfaction^b	–	2	–	3	–	6	–	4	–	ns
Home nursing services	0	0	3	6	15	15	5	8	< 0.0001	< 0.001
^aAll the results are presented as percentages except mean age. ^bThese items were asked only in 1998–99. ^cStatistical tests were made only between persons with 1 to 5 and > 5 drugs separately in 1990–91 and 1998–99. Categorial variables were tested with Chi-square test, and continuous variables with Student`s t-test. ns = no statistical significance.

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