Pharmaceutical Treatment for Alzheimer’s Disease and Related Dementias: Utilization and Disparities

Details

• Alternative Title:
  J Alzheimers Dis
• Personal Author:
  Barthold, Douglas ; Joyce, Geoffrey ; Ferido, Patricia ; Drabo, Emmanuel F. ; Marcum, Zachary A. ; Gray, Shelly L. ; Zissimopoulos, Julie
• Description:
  Background:
  
  Four prescription drugs (donepezil, galantamine, memantine, and rivastigmine) are approved by the US FDA to treat symptoms of Alzheimer’s disease (AD). Even modest effectiveness could potentially reduce the population-level burden of AD and related dementias (ADRD), especially for women and racial/ethnic minorities who have higher incidence of ADRD.
  
  Objective:
  
  Describe the prevalence of antidementia drug use and timing of initiation relative to ADRD diagnosis among a nationally representative group of older Americans, and if there are disparities in prevalence and timing by sex and race/ethnicity.
  
  Methods:
  
  Descriptive analyses and logistic regressions of Medicare claims (2008–2016) for beneficiaries who had an ADRD or dementia-related symptom diagnosis, or use of an FDA approved drug for AD. We investigate prevalence of use and timing of treatment initiation relative to ADRD diagnosis across time and beneficiary characteristics (age, sex, race/ethnicity, socioeconomic status, comorbidities).
  
  Results:
  
  Among persons diagnosed with ADRD or related symptoms, 33.3% used an approved drug over the study period. Odds of use was higher among Whites than non-Whites. Among ADRD drug users, 40% initiated use within 6 months of the initial ADRD or related symptoms diagnosis, and 16% initiated prior to a diagnosis. We observed disparities by race/ethnicity: 28% of Asians, 24% of Hispanics, 16% of Blacks, and 15% of Whites initiated prior to diagnosis.
  
  Conclusions:
  
  The use of antidementia drugs is relatively low and varies widely by race/ethnicity. Heterogeneity in timing of initiation and use may affect health and cost outcomes, but these effects merit further study.
  
  
• Subjects:
  Aged Aged, 80 And Over Alzheimer Disease Cholinesterase Inhibitors Dementia Donepezil Dopamine Agents Female Galantamine Healthcare Disparities Humans Male Medicare Memantine Nootropic Agents Patient Acceptance Of Health Care Rivastigmine Treatment Outcome United States

  More +
• Keywords:
  Acetylcholinesterase Inhibitors Alzheimer’s Disease And Related Dementias Disparities Donepezil Galantamine Memantine Rivastigmine
• Source:
  J Alzheimers Dis. 76(2):579-589
• Pubmed ID:
  32538845
• Pubmed Central ID:
  PMC7825250
• Document Type:
  Journal Article
• Funding:
  R01 HL126804/HL/NHLBI NIH HHSUnited States/ ; U01CE002967/ACL/ACL HHSUnited States/ ; R01 HL130462/HL/NHLBI NIH HHSUnited States/ ; P01 AG033559/AG/NIA NIH HHSUnited States/ ; R34 AG049652/AG/NIA NIH HHSUnited States/ ; K76 AG059929/AG/NIA NIH HHSUnited States/ ; R01 AG055401/AG/NIA NIH HHSUnited States/ ; U01 AG006781/AG/NIA NIH HHSUnited States/ ; P30 AG043073/AG/NIA NIH HHSUnited States/
• Volume:
  76
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2a204bbfa0e4ea61a6090f38fd428787f5f8a986cf9c55f92279dbc7e3937c16
• Download URL:
  https://stacks.cdc.gov/view/cdc/158037/cdc_158037_DS1.pdf
• File Type:
  [PDF - 447.54 KB ]