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. 2017 Nov 26:4:1-10.
doi: 10.1016/j.trci.2017.10.008. eCollection 2018.

Longitudinal patterns of potentially inappropriate medication use following incident dementia diagnosis

Christine M Ramsey  1 , Danijela Gnjidic  2 , George O Agogo  1 , Heather Allore  1   3 , Daniela Moga  4   5   6
Affiliations

Longitudinal patterns of potentially inappropriate medication use following incident dementia diagnosis

Christine M Ramsey et al. Alzheimers Dement (N Y). .

Abstract

Introduction: Potentially inappropriate medication (PIM) use in older adults with dementia is an understudied area. We assessed longitudinal changes in PIM exposure by dementia type following dementia diagnosis.

Methods: We followed 2448 participants aged ≥65 years (52% women, 85.5% Caucasian, mean age 80.9 ± 7.5 years) diagnosed with dementia after enrollment in the National Alzheimer's Coordinating Center (2005-2014). We estimated the association between dementia type and PIM annually for 2 years after diagnosis, using Generalized Estimating Equations.

Results: Participants with Lewy body dementia had more PIM use, and participants with frontotemporal dementia had less PIM use than participants with Alzheimer's disease. In the first year following diagnosis, total number of medications increased, on average, by 10% for Alzheimer's disease and 15% for Lewy body dementia (P < .05 for both).

Discussion: A tailored approach aimed at optimizing drug therapy is needed to mitigate PIM exposure to improve medical care for individuals with dementia.

Keywords: Beers' Criteria; Dementia; Inappropriate medication use; National Alzheimer's Disease Coordinating Center; Polypharmacy.

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Figures

Fig. 1
Fig. 1
Study flow chart for sample of 2380 NACC participants, 2005–2014. Abbreviation: NACC, National Alzheimer's Disease Coordinating Center.
Fig. 2
Fig. 2
Adjusted odds ratios for use of Beers' Criteria medications among ever-users (A), ADS score among ever-users (B), and total medications in non-Alzheimer's related dementias compared to Alzheimer's disease (C) over 2 years following dementia diagnosis. Abbreviations: LBD, Lewy body dementia; AD, Alzheimer's disease; VD, vascular dementia; FTD, frontotemporal dementia.
Fig. 3
Fig. 3
Adjusted marginal means (least squares mean estimates) for Beers' Criteria medications among ever-users (A), Anticholinergic Drug Scale score among ever-users (B), and total medications by dementia type over 2 years following diagnosis (C).
See this image and copyright information in PMC

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