Utilization of antihypertensives, antidepressants, antipsychotics, and hormones in Alzheimer disease.
This study explores the longitudinal relationship between patient characteristics and use of 4 drug classes (antihypertensives, antidepressants, antipsychotics, and hormones) that showed significant changes in use rates over time in patients with Alzheimer disease. Patient/caregiver-reported prescription medication usage was categorized by drug class for 201 patients from the Predictors Study. Patient characteristics included use of cholinesterase inhibitors and/or memantine, function, cognition, living situation, baseline age, and sex. Assessment interval, year of study entry, and site were controlled for. Before adjusting for covariates, useage increased for antihypertensives (47.8% to 62.2%), antipsychotics (3.5% to 27.0%), and antidepressants (32.3% to 40.5%); use of hormones decreased (19.4% to 5.4%). After controlling for patient characteristics, effects of time on the use of antidepressants were no longer significant. Antihypertensive use was associated with poorer functioning, concurrent use of memantine, and older age. Antipsychotic use was associated with poorer functioning and poorer cognition. Antidepressant use was associated with younger age, poorer functioning, and concurrent use of cholinesterase inhibitors and memantine. Hormone use was associated with being female and younger age. Findings suggest accurate modeling of the Alzheimer disease treatment paradigm for certain subgroups of patients should include antihypertensives and antipsychotics in addition to cholinesterase inhibitors and memantine.
Geriatric Research, Education, and Clinical Center (GRECC) and Health Services Research and Development (HSR&D) Center for Study of Health Care across Systems and Sites of Care, James J. Peters VA Medical Center, Bronx, New York, NY 10468, USA. carolyn.zhu@mssm.edu
Carolyn W
CW
Zhu
Elayne E
EE
Livote
Kristin
K
Kahle-Wrobleski
Nikolaos
N
Scarmeas
Marilyn
M
Albert
Jason
J
Brandt
Deborah
D
Blacker
Mary
M
Sano
Yaakov
Y
Stern
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010818:Practice Patterns, Physicians'
D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D014150:Antipsychotic Agents; D006728:Hormones