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Alzheimers Dement (N Y). 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.

Author information

1
Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
2
Faculty of Pharmacy and Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia.
3
Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
4
Department of Pharmacy Practice and Science, University of Kentucky, College of Pharmacy, Lexington, KY, USA.
5
Department of Epidemiology, University of Kentucky, College of Public Health, Lexington, KY, USA.
6
University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA.

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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