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Longitudinal medication usage in Alzheimer disease patients
Carolyn W Zhu1, Elayne E Livote, Kristin Kahle-Wrobleski
1*This Geriatric Research, Education, and Clinical Center (GRECC) and HSR&D Center for the Study of Health Care Across Systems and Sites of Care, James J. Peters VA Medical Center, Bronx †Brookdale Department of Geriatrics, Mount Sinai School of Medicine ∥Gertrude H. Sergievsky Center and the Department of Neurology, Columbia University Medical Center **Department of Psychology, Mount Sinai School of Medicine ‡Eli Lily & Company §Cognitive Neuroscience Division of the Taub Institute for Research in Alzheimer's Disease and the Aging Brain, New York, NY ¶Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD ♯Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Cholinesterase inhibitors (ChEIs) use declined while memantine use increased in Alzheimer disease (AD) patients over six years. ChEI use correlated with better function, while memantine use linked to better function but poorer cognition.
Area of Science:
- Neuroscience
- Pharmacology
- Geriatrics
Background:
- Alzheimer disease (AD) management involves cholinesterase inhibitors (ChEIs) and memantine.
- Understanding medication use patterns and influencing factors is crucial for optimizing AD care.
Purpose of the Study:
- To analyze trends in ChEI and memantine utilization among AD patients.
- To investigate the relationship between patient characteristics and the use of these medications over time.
Main Methods:
- Longitudinal study of 201 probable AD patients over 6 years.
- Random effects logistic regression to assess predictors of ChEI/memantine use.
- Analysis included function, cognition, comorbidities, psychosis, age, sex, and living situation.
Main Results:
- ChEI use decreased from 80.6% to 73.0%; memantine use increased from 2.0% to 45.9%.
- ChEI use associated with better function, no psychotic symptoms, and younger age.
- Memantine use linked to better function, poorer cognition, home living, and later study entry/assessment.
Conclusions:
- Observed medication use trends align with current clinical guidelines for AD treatment.
- Increasing memantine use reflects its expanded application in moderate-to-severe AD.
- Patient characteristics significantly influence the prescription patterns of AD medications.
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