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P‐200: Factors associated with practice effects and decline in MIS scores in the preadvise antioxidant Alzheimer's disease prevention trial
Author(s) -
Schmitt Frederick A.,
Kryscio Richard J.,
Abner Erin L.,
Mendiondo Marta S.,
Runyons Cecil,
Caban-Holt Allison,
Markesbery William R.
Publication year - 2007
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.2007.04.163
Subject(s) - medicine , dementia , cohort , logistic regression , family history , ethnic group , demography , gerontology , disease , odds ratio , odds , physical therapy , sociology , anthropology
their effectiveness is unknown. Objective(s): To describe the use of these medications in a population-based longitudinal study, characteristics of individuals that use these drugs, and to preliminary assess their impact on mortality. Methods: 302 individuals with incident AD, identified in a population-based sample of elderly persons in Cache County, Utah, were followed longitudinally with in-home visits for a mean of 2.8 years (range: 0.1-9.8) after diagnosis. T-tests and Fischer’s exact tests were used to determine baseline differences in demographic, health, and functional characteristics between those who had ever regularly used a dementia medication over the follow-up compared to those who did not. Regular use was defined as taking the medication 4 times per week. Cox proportional hazards regressions were used to assess the association between use of these medications and mortality. Covariates included baseline age, GMHR, MMSE, and dementia duration, education and presence of an APOE E4 allele. Results: 54 participants (18.2%) regularly used cholinesterase inhibitors or memantine at any point over the follow-up. Regular users were significantly younger (80.9 vs. 86.6, p 0.001), more likely to have an APOE E4 allele (57.4% vs. 39.5%, p 0.01), and less likely to die over the follow-up (36.8% vs. 69.4%, p 0.001). Notably, there were no differences in self-reported health characteristics between the two groups at the time of diagnosis. Preliminary assessments with Cox proportional hazards suggest a reduced risk of mortality with use of a dementia medication. There was a dose response effect such that individuals taking a medication over 2 or more visits were less likely to die compared to those taking a medication at 1 visit or not at all. Conclusions: Less than 20% of participants in this population-based study regularly took cholinesterase inhibitors or memantine. Baseline health characteristics did not explain use. Preliminary results suggest that use of these medications may be associated with reduced mortality. Additional analyses with time-dependent analyses and more cases are needed to confirm these findings.