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Longitudinal medication usage in Alzheimer disease patients

Authors

Zhu, Carolyn W., Livote, Elayne E., Kahle-Wrobleski, Kristin, Scarmeas, Nikolaos, Albert, Marilyn, Brandt, Jason, Blacker, Deborah, Sano, Mary, Stern, Yaakov

Journal

Alzheimer Disease and Associated Disorders, Volume: 24, No.: 4, Pages.: 354-359

Year of Publication

2010

Abstract

This study examined in detail patterns of cholinesterase inhibitors (ChEIs) and memantine use and explored the relationship between patient characteristics and such use. Patients with probable Alzheimer disease AD (n=201) were recruited from the Predictors Study in 3 academic AD centers and followed from early disease stages for up to 6 years. Random effects logistic regressions were used to examine effects of patient characteristics on ChEIs/memantine use over time. Independent variables included measures of function, cognition, comorbidities, the presence of extrapyramidal signs, psychotic symptoms, age, sex, and patient’s living situation at each interval. Control variables included assessment interval, year of study entry, and site. During a 6-year study period, rate of ChEIs use decreased (80.6% to 73.0%) whereas memantine use increased (2.0% to 45.9%). Random effects logistic regression analyses showed that ChEI use was associated with better function, no psychotic symptoms, and younger age. Memantine use was associated with better function, poorer cognition, living at home, later assessment interval, and later year of study entry. Results suggest that high rate of ChEI use and increasing memantine use over time are consistent with current practice guidelines of initiation of ChEIs in mild-to-moderate AD patients and initiation of memantine in moderate-to-severe patients. (PsycINFO Database Record (c) 2012 APA, all rights reserved). (journal abstract)

Bibtex Citation

@article{Zhu_2010, doi = {10.1097/wad.0b013e3181e6a17a}, url = {http://dx.doi.org/10.1097/WAD.0b013e3181e6a17a}, year = 2010, publisher = {Ovid Technologies (Wolters Kluwer Health)}, volume = {24}, number = {4}, pages = {354--359}, author = {Carolyn W. Zhu and Elayne E. Livote and Kristin Kahle-Wrobleski and Nikolaos Scarmeas and Marilyn Albert and Jason Brandt and Deborah Blacker and Mary Sano and Yaakov Stern}, title = {Longitudinal Medication Usage in Alzheimer Disease Patients}, journal = {Alzheimer Disease {&} Associated Disorders} }

Keywords

alzheimer’s disease, alzheimers disease patients, and, cholinesterase, cholinesterase inhibitors, client characteristics, drug therapy, inhibitors, medication usage, memantine, patient characteristics, patients

Countries of Study

USA

Types of Dementia

Alzheimer’s Disease

Types of Study

Cohort Study, Correlation Study (also known as Ecological Study), Cost and service use study

Type of Outcomes

Cognition, Service use or cost reductions (incl. hospital use reduction, care home admission delay)

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime