TY - JOUR
T1 - Acetylcholinesterase inhibitors in assisted living
T2 - Patterns of use and association with retention
AU - Rosenblatt, Adam
AU - Samus, Quincy M.
AU - Onyike, Chiadi U.
AU - Baker, Alva S.
AU - McNabney, Matthew
AU - Mayer, Lawrence S.
AU - Brandt, Jason
AU - Lyketsos, Constantine G.
PY - 2008/2
Y1 - 2008/2
N2 - Objectives: To describe patterns of Acetylcholinesterase inhibitor (ACI) use in an Assisted Living (AL) population, and the association of ACIs with retention in AL. Methods: As part of the Maryland Assisted Living Study (MD-AL), 198 residents of 22 ALs were evaluated. Dementia was diagnosed in 134, and specifically Alzheimer's disease (AD) in 79, by an expert consensus panel. Data was collected on ACI agent and dose. Vital status and location were recorded every 6 months. Other data included age, duration of residence, general medical health rating (GHMR), Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD) and number of non-psychiatric medications. Results: The overall ACT treatment rate was 31%. 34.5% of participants with mild to moderate AD were taking ACIs. Only two in seven participants taking rivastigmine were taking an adequate dose. Participants with AD on ACI's did not differ significantly from those not on ACI's in any of the secondary measures except age and duration of residence, those on the agents being somewhat younger and more recently admitted. For participants with AD, only ACI use was significantly associated with retention in AL at 6 months, with a relative risk of death or discharge to higher level care of 0.217. Baseline MMSE was associated with retention for those with non-AD dementia. In a survival analysis ACI use was associated with 228.75 days longer retention in participants with AD. Conclusion: ACIs have low rates of use in AL and are associated with better retention for residents with AD.
AB - Objectives: To describe patterns of Acetylcholinesterase inhibitor (ACI) use in an Assisted Living (AL) population, and the association of ACIs with retention in AL. Methods: As part of the Maryland Assisted Living Study (MD-AL), 198 residents of 22 ALs were evaluated. Dementia was diagnosed in 134, and specifically Alzheimer's disease (AD) in 79, by an expert consensus panel. Data was collected on ACI agent and dose. Vital status and location were recorded every 6 months. Other data included age, duration of residence, general medical health rating (GHMR), Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD) and number of non-psychiatric medications. Results: The overall ACT treatment rate was 31%. 34.5% of participants with mild to moderate AD were taking ACIs. Only two in seven participants taking rivastigmine were taking an adequate dose. Participants with AD on ACI's did not differ significantly from those not on ACI's in any of the secondary measures except age and duration of residence, those on the agents being somewhat younger and more recently admitted. For participants with AD, only ACI use was significantly associated with retention in AL at 6 months, with a relative risk of death or discharge to higher level care of 0.217. Baseline MMSE was associated with retention for those with non-AD dementia. In a survival analysis ACI use was associated with 228.75 days longer retention in participants with AD. Conclusion: ACIs have low rates of use in AL and are associated with better retention for residents with AD.
KW - Acetylcholinesterase inhibitors
KW - Assited living
KW - Dementia
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U2 - 10.1002/gps.1859
DO - 10.1002/gps.1859
M3 - Article
C2 - 17676652
AN - SCOPUS:39749091211
SN - 0885-6230
VL - 23
SP - 178
EP - 184
JO - International journal of geriatric psychiatry
JF - International journal of geriatric psychiatry
IS - 2
ER -