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Undertreatment of patients with Alzheimer's disease in an elderly United States population
Author(s) -
Sano Mary,
Amatniek Joan,
Feely Morgan,
Sinyak Feliks,
Holton Denise,
Ascher Steve,
Finkel Sanford I.
Publication year - 2005
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2005.09.011
Subject(s) - medicine , galantamine , population , ethnic group , disease , gerontology , demographics , census , polypharmacy , family medicine , donepezil , dementia , demography , environmental health , sociology , anthropology
Background The aim of this study was to assess the undertreatment of elderly mild to moderate Alzheimer's disease (AD) patients in the United States utilizing baseline data from a community‐based trial that has established comparability to national survey samples on demographic characteristics. Methods Baseline data were used from an open‐label, 12‐week, postapproval study of compliance with galantamine, an AChEI and nicotinic receptor modulator, and vitamin E. A total of 2,114 patients from 406 community‐based US practices in which physicians had previously treated patients with acetylcholinesterase inhibitors (AChEIs) were included in the study. This population reflects a large, ethnically diverse patient pool consistent with the demographics of the elderly population in the United States, atypical of those enrolled in most AD trials. Results The majority of patients (64.5%) were described by either themselves or their caregivers as not having received prior AChEI treatment. Positive associations were found between past AChEI treatment and longer time since diagnosis, white race, higher education, medical care by a neurologist, and older caregivers. The likelihood of having received previous AChEI treatment was higher among white patients (61.9%) than among those from other ethnic groups combined (25.8%). Conclusions The similarity of patient demographic characteristics to the 2000 US Census figures for the population aged ≥65 years makes this data set a potentially powerful tool for planning public health initiatives. Findings suggest that patients with mild to moderate AD are undertreated and that specialist and nonspecialist organizations should discuss and implement ways to optimize management of this disease.