Trends in the Use of Medications and Supplements to Treat or Prevent Dementia: A Population-based Study

Abstract

Objective: To examine older adults' use over time of agents to treat or prevent dementia or enhance memory.

Design: Longitudinal community study with 10-year annual follow-up (2006-2017).

Setting: Population-based cohort.

Participants: A total of 1982 individuals with a mean (SD) age of 77 (7.4) years at baseline.

Measurements: Demographics, self-report, direct inspection of prescription antidementia drugs and nonprescription supplements, cognitive and functional assessments, Clinical Dementia Rating (CDR®) Dementia Staging Instrument.

Results: Supplement use was reported by 27% to 42% of participants over 10 years. Use was associated with younger age, high school or greater education, good to excellent self-reported health, higher memory test scores, and absence of cognitive impairment or dementia (CDR=0). Over the same period, about 2% to 6% of participants took prescription dementia medications over 10 years. Use was associated with lower memory test scores, at least mild cognitive impairment (CDR≥0.5), fair to poor self-rated health, and high school or lesser education.

Conclusions: The use of both prescription drugs and supplements increased over time, except for decreases in ginkgo and vitamin E. Prescription drug use appeared in line with prescribing guidelines. Supplement use was associated with higher education and better self-rated health; it persists despite a lack of supportive evidence.

Figure 1A.. Dementia Drug Use Stratified by Age at Baseline.

Little difference in percent of use is seen between age groups at Year 1 (baseline), but by the end of the ten-year study period, the percentage of prescription dementia drug users is greatest in the middle age group (75–84) and lowest in the oldest age group (85+).

Figure 1B.. Supplement Use Stratified by Age at Baseline.

Over the ten-year study period, participants in the youngest age group (65–74 years) had the highest proportion of memory supplement users while the oldest age group (85+) had the lowest percentage of supplement use.

Figure 1C.. Dementia Drug Use Stratified by Clinical Dementia Rating at Each Annual Assessment.

Of those with a Clinical Dementia Rating (CDR) of 1 or greater, prescription dementia drug use ranged from 26% at baseline to 50% at year 10. For those with a CDR of 0.5, use increased from 6% to 13%; for people with a CDR of 0, use remained mostly stable with 0.6% at baseline and 1% at year 10.

Figure 1D.. Supplement Use Stratified by Clinical Dementia Rating at Each Annual Assessment.

Use of memory supplements increased over the course of the study for all CDR groups. Those with a CDR of 0 maintained the highest percentage of users over the ten-year period, while those with a CDR of 1 or greater had the lowest percentage of users.