University of Oulu

Alastalo, A., Tolppanen, A., Nietola, M., Haapea, M., Miettunen, J., Hartikainen, S., & Jääskeläinen, E. (2022). Prevalence and characteristics of psychiatric morbidity treated in specialized health care in a nationwide cohort of people with newly diagnosed Alzheimer’s disease. Acta Psychiatrica Scandinavica, 145(5), 507–516.

Prevalence and characteristics of psychiatric morbidity treated in specialized health care in a nationwide cohort of people with newly diagnosed Alzheimer’s disease

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Author: Alastalo, Aleksi1,2; Tolppanen, Anna-Maija3; Nietola, Miika4;
Organizations: 1Center for Life Course Health Research, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3School of Pharmacy, University of Eastern Finland, Kuopio, Finland
4Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
5Department of Psychiatry, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2022
Publish Date: 2022-11-02


Objective: Psychiatric disorders have been implied as both risk factors and prodromal symptoms of Alzheimer’s disease (AD). A better understanding of the history of psychiatric morbidity in people with AD may aid with understanding this relationship and highlight challenges in diagnosing AD in people with concomitant psychiatric disorders.

Methods: Medication use and Alzheimer’s disease (MEDALZ) study is a nationwide register-based cohort of people (n = 70,718) who received a clinically verified AD diagnosis in Finland in 2005–2011 and were community-dwelling at the time of diagnosis. The study population was divided into four groups based on psychiatric morbidity treated in specialized health care. We characterized the groups using data of psychiatric and somatic illnesses, psychotropic drug use, and socioeconomic factors and investigated factors associated with prodromal AD.

Results: Altogether, 4.3% of cohort members had a psychiatric diagnosis at least five years before AD diagnosis, 3.1% had a psychiatric diagnosis only up to five years before AD diagnosis, and 1.1% had a psychiatric diagnosis both less and more than 5 years before AD. Belonging to the Prodromal group (psychiatric diagnosis within 5 years before AD diagnosis) was most strongly associated with substance abuse (RR 65.06, 95%CI 55.54–76.22). Other associated factors with the Prodromal group were female gender, use of psychotropics, stroke, and asthma/COPD.

Conclusion: Substance abuse and psychotropic drug use are common five years before AD diagnosis. These can be potential markers of possible prodromal symptoms of AD and should be acknowledged in clinical work.

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Series: Acta psychiatrica Scandinavica
ISSN: 0001-690X
ISSN-E: 1600-0447
ISSN-L: 0001-690X
Volume: 145
Issue: 5
Pages: 507 - 516
DOI: 10.1111/acps.13423
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
317 Pharmacy
Funding: This work was supported by a grant from the Academy of Finland (grant number 316563) and Oulu University Hospital funding (basic government funding for hospitals). The funders had no role in the study design, data collection, data analysis, interpreting the results, or the decision to publish the article.
Academy of Finland Grant Number: 316563
Detailed Information: 316563 (Academy of Finland Funding decision)
Copyright information: © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.