Antidementia drugs: prescription by level of cognitive impairment or by socio-economic group?
OBJECTIVE
We aimed to investigate for the first time whether cholinesterase inhibitor prescription was associated with economic status in a population of people with dementia.


METHODS
We recruited 215 people with dementia, living independently, who were consecutively referred to five Community Mental Health Teams in London and Essex. We tested our hypothesis that home owners were more likely to be prescribed cholinesterase inhibitors than those who rented their accommodation.


RESULTS
People who owned their home were four times more likely to be prescribed cholinesterase inhibitors (OR 4.2, 1.8-9.8; p = 0.001). Younger age, fewer neuropsychiatric symptoms, having a dementia diagnosis for which cholinesterase inhibitors were recommended and longer time since diagnosis also predicted prescription, but severity of cognitive impairment did not.


CONCLUSIONS
Despite high-profile guidelines that NHS cholinesterase prescribing should be restricted to people with moderate dementia, being a home owner was a strong predictor of prescription, while dementia severity was not. We recommend that health services should be audited to ensure that access to treatment increases in those who are socioeconomically disadvantaged.
Department of Mental Health Sciences (Archway campus), University College London, Highgate Hill, London N19 5NL, UK. ccooper@doctors.org.uk
Claudia
C
Cooper
Martin
M
Blanchard
Amber
A
Selwood
Gill
G
Livingston
D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy* / Q000503:physiopathology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004739:England; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D012720:Severity of Illness Index; D012923:Social Class; D013222:State Medicine; D011795:Surveys and Questionnaires
D002800:Cholinesterase Inhibitors