Use of lipid-lowering drugs in older adults with and without dementia: a community-based epidemiological study.
OBJECTIVE
To compare the use of lipid-lowering drugs in community-dwelling older adults with and without dementia.


METHODS
Comparison of lipid-lowering drug use by demented cases and nondemented controls based on secondary analysis of data from a longitudinal epidemiologic study.


METHODS
Longitudinal study of a largely rural, low- socioeconomic-status, community-based cohort of older persons residing in the mid-Monongahela Valley of South-west Pennsylvania (the Monongahela Valley Independent Elders Survey).


METHODS
Eight hundred forty-five individuals of mean +/- standard deviation (SD) age of 80.5 +/- 4.6, participating in the fifth biennial wave of data collection.


METHODS
Demographics; medical history; medication regimen (including examination of prescription bottle labels); self-report of most recent visit to primary care physician (PCP); and standardized clinical assessment to determine presence of dementia, including Clinical Dementia Rating (CDR).


RESULTS
One hundred seventy participants (20.1% of total subject cohort) had dementia, with a CDR of 0.5 or greater. Mean ages of demented and nondemented individuals were 83.5 +/- 5.1 and 79.8 +/- 4.2, respectively. Similar proportions, 87.7% and 89.5%, of these groups reported PCP visits in the previous year. Of the total sample, 9.4% (3.5% of the demented and 10.8% of the nondemented) were taking lipid-lowering drugs. After adjustment for age, sex, education, visit with PCP within the past year, and potential confounding clinical and lifestyle variables (self-reported heart disease, stroke or transient ischemic attacks, hypertension, smoking, and alcohol consumption), dementia was associated with a lower likelihood of taking a lipid-lowering drug (odds ratio = 0.39, 95% confidence interval = 0.16-0.95). In post hoc subgroup analyses, similar results were found when restricting lipid-lowering drugs to statins alone but were not statistically significant. Drug use was not associated with severity of dementia (CDR = 0.5 vs CDR >or= 1).


CONCLUSIONS
Demented individuals were less likely than their nondemented counterparts to be taking lipid-lowering drugs. This finding could reflect different prescribing patterns by physicians for demented and nondemented patients or a possible protective effect of these drugs against dementia.
Rodriguez
Eric G
EG
Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. rodriguezeg@msx.upmc.edu
Dodge
Hiroko H
HH
Birzescu
Maria A
MA
Stoehr
Gary P
GP
Ganguli
Mary
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
D000960:Hypolipidemic Agents