Comparison of psychotropic medication use before and after parental death by number of siblings

BACKGROUND: Ageing populations and decreasing family size suggest more persons might need to take care of their aging parents for longer periods and eventually cope with the loss of their parents with fewer siblings. However, little is known about how number of siblings or specific causes of death, such as dementia, may moderate the burden of impending parental death and coping with parental loss. METHODS: Using Finnish population registers, we assess annual psychotropic medication use among adult offspring around the time of parental death. We use deaths that occurred in Finland during 2004 to 2016 and assess medication use up to two years before and after parental death with generalized estimation equations while controlling for sociodemographic factors. We assess whether sibship size moderates medication use and whether the associations differ by parental causes of death (e.g. dementia, neoplasms or cardiovascular diseases) that convey information about the abruptness of death and care burden prior to death. RESULTS: Before and after parental death, psychotropic medication use increased more among individuals with fewer siblings. The differences were largest in the first year after parental death, e.g., the increase in medication prevalence was 2.8% (95% CI: 2.5; 3.1) among only children, 2.2% (2.0; 2.2) with those with one to two siblings and 1.1% (0.4; 1.8) with those with three or more siblings. There were little differences between causes of death. Our results are preliminary and based on a 10% subsample of deaths in Finland (n = 110,000). CONCLUSIONS: Parental death was associated with an increase in adult offspring psychotropic medication use that was larger among those with fewer siblings. Decreases in sibship sizes may significantly increase the care burden on offspring caring for their aging parents. Yet, more studies are needed to establish how sibling characteristics moderate these associations. KEY MESSAGES: • There is a clear increase in adult offspring psychotropic medication use in the event of a parental death, yet there was little variation according to cause of death. • Having more siblings was associated with a smaller and belated increase in psychotropic medication use in the event of parental death, which could be interpreted as sharing the burden.