Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals

Alok Joshi, Stephen Todd, David Finn, Paula McClean, KongFatt Wong-Lin

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Background: Dementia is a group of symptoms that largely affects older people. The majority of patients face behavioural and psychological symptoms (BPSD) during the course of their illness. Alzheimer’s disease (AD) and vascular dementia (VaD) are two of the most prevalent types of dementia. Available medications provide symptomatic benefits and provide relief from BPSD and associated health issues. However, it is unclear how specific dementia, antidepressant, antipsychotic, antianxiety, and mood stabiliser drugs, used in the treatment of depression and dementia subtypes are prescribed in hospital admission, during hospital stay, and at the time of discharge. To address this, we apply multi-dimensional data analytical approaches to understand drug prescribing practices within hospitals in England and Wales.

Methods: We made use of the UK National Audit of Dementia (NAD) dataset and pre-processed the dataset. We evaluated the pairwise Pearson correlation of the dataset and selected key data features which are highly correlated with dementia subtypes. After that, we selected drug prescribing behaviours (e.g. specific medications at the time of admission, during the hospital stay, and upon discharge), drugs and disorders. Then to shed light on the relations across multiple features or dimensions, we carried out multiple regression analyses, considering the number of dementia, antidepressant, antipsychotic, antianxiety, mood stabiliser, and antiepileptic/anticonvulsant drug prescriptions as dependent variables, and the prescription of other drugs, number of patients with dementia subtypes (AD/VaD), and depression as independent variables.

Results: In terms of antidepressant drugs prescribed in hospital admission, during stay and discharge, the number of sertraline and venlafaxine prescriptions were associated with the number of VaD patients whilst the number of mirtazapine prescriptions was associated with frontotemporal dementia patients. During admission, the number of lamotrigine prescriptions was associated with frontotemporal dementia patients, and with the number of valproate and dosulepin prescriptions. During discharge, the number of mirtazapine prescriptions was associated with the number of donepezil prescriptions in conjunction with frontotemporal dementia patients. Finally, the number of prescriptions of donepezil/memantine at admission, during hospital stay and at discharge exhibited positive association with AD patients.

Conclusion: Our analyses reveal a complex, multifaceted set of interactions among
prescribed drug types, dementia subtypes, and depression.
Original languageEnglish
Article number262
JournalBMC Medical Informatics and Decision Making
Issue number1
Early online date7 Oct 2022
Publication statusPublished online - 7 Oct 2022

Bibliographical note

Funding Information:
This work was supported by the European Union’s INTERREG VA Programme, managed by the Special EU Programmes Body (SEUPB (Centre for Personalised Medicine, IVA 5036)), Alzheimer’s Research UK (ARUK) NI Pump Priming (A.J.,P.L.M., K.W.-L.), and Ulster University Research Challenge Fund (A.J.,S.T.,P.L.M., K.W.-L.). The views and opinions expressed in this paper do not necessarily reflect those of the European Commission or the SEUPB.

Publisher Copyright:
© 2022, The Author(s).


  • Dementia
  • Alzheimer's disease
  • Vascular dementia
  • depression
  • antidepressant
  • antipsychotic
  • antianxiety
  • drug prescription
  • hospital admission, stay and discharge
  • Antidepressant
  • Stay and discharge
  • Alzheimer’s disease
  • Hospital admission
  • Depression
  • Antianxiety
  • Antipsychotic
  • Drug prescription


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