{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:00:21Z","timestamp":1792040421767,"version":"4.4.0"},"reference-count":37,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,6,17]]},"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of the Medicine use and Alzheimer's disease (MEDALZ) study is to investigate the changes in medication and healthcare service use among persons with Alzheimer's disease (AD) and to evaluate the safety and effectiveness of medications in this group. This is important, because the number of persons with AD is rapidly growing and even though they are a particularly vulnerable patient group, the number of representative, large-scale studies with adequate follow-up time is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>MEDALZ contains all residents of Finland who received a clinically verified diagnosis of AD between 2005 and 2011 and were community-dwelling at the time of diagnosis (N=70\u2005719). The diagnosis is based on the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCS-ADRDA) and Diagnostic and Statistical Manual Fourth Edition (DSM-IV) criteria for Alzheimer's disease. The cohort contains socioeconomic data (education, occupational status and taxable income, 1972\u20132012) and causes of death (2005\u20132012), data from the prescription register (1995\u20132012), the special reimbursement register (1972\u20132012) and the hospital discharge register (1972\u20132012). Future updates are planned.<\/jats:p>\n                    <jats:p>The average age was 80.1\u2005years (range 34.5\u2013104.6\u2005years). The majority of cohort (65.2%) was women. Currently, the average length of follow-up after AD diagnosis is 3.1\u2005years and altogether 26\u2005045 (36.8%) persons have died during the follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Altogether 53% of the cohort had used psychotropic drugs within 1\u2005year after AD diagnoses. The initiation rate of for example, benzodiazepines and related drugs and antidepressants began to increase already before AD diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Future plans<\/jats:title>\n                    <jats:p>We are currently assessing if these, and other commonly used medications are related to adverse events such as death, hip fractures, head injuries and pneumonia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-012100","type":"journal-article","created":{"date-parts":[[2016,7,14]],"date-time":"2016-07-14T02:52:22Z","timestamp":1468464742000},"page":"e012100","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":85,"title":["Cohort profile: the Finnish Medication and Alzheimer's disease (MEDALZ) study"],"prefix":"10.1136","volume":"6","author":[{"given":"Anna-Maija","family":"Tolppanen","sequence":"first","affiliation":[{"name":"School of Pharmacy, University of Eastern Finland, Kuopio, Finland"},{"name":"Research Center for Comparative Effectiveness and Patient Safety, University of Eastern Finland, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Taipale","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Eastern Finland, Kuopio, Finland"},{"name":"Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjaana","family":"Koponen","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Eastern Finland, Kuopio, Finland"},{"name":"Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piia","family":"Lavikainen","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Eastern Finland, Kuopio, Finland"},{"name":"Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Tanskanen","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland"},{"name":"National Institute for Health and Welfare, Helsinki, Finland"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Tiihonen","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirpa","family":"Hartikainen","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Eastern Finland, Kuopio, Finland"},{"name":"Kuopio Research Center for Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland"},{"name":"Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,7,13]]},"reference":[{"key":"2025121404313053000_6.7.e012100.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61340-X"},{"key":"2025121404313053000_6.7.e012100.2","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.jalz.2016.03.001","article-title":"2016 Alzheimer's disease facts and figures","volume":"12","author":"Alzheimer's Association","year":"2016","journal-title":"Alzheimers Dement"},{"key":"2025121404313053000_6.7.e012100.3","unstructured":"World Health Organization. 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