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Co-morbidity and drug treatment in Alzheimer's disease. A cross sectional study of participants in the dementia study in northern Norway
Inappropriate medical treatment of co-morbidities in Alzheimer's disease (AD) is an increasing concern in geriatric medicine. The objective of this study was to compare current drug use related to co-morbidity between individuals with a recent diagnosis of AD and a cognitively healthy control g...
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| Published in: | BMC geriatrics 2011-10, Vol.11 (1), p.58-58, Article 58 |
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| creator | Andersen, Fred Viitanen, Matti Halvorsen, Dag S Straume, Bjørn Engstad, Torgeir A |
| description | Inappropriate medical treatment of co-morbidities in Alzheimer's disease (AD) is an increasing concern in geriatric medicine. The objective of this study was to compare current drug use related to co-morbidity between individuals with a recent diagnosis of AD and a cognitively healthy control group in a population based clinical trial in Northern Norway.
Nine rural municipalities with 70,000 inhabitants in Northern Norway.
PARTICIPANTS with and without AD recruited in general practice and by population based screening.187 participants with a recent diagnosis of AD were recruited among community dwellers. Of 791 respondents without cognitive symptoms, 500 were randomly selected and invited to further clinical and cognitive testing. The final control group consisted of 200 cognitively healthy individuals from the same municipalities. Demographic characteristics, data on medical history and current medication were included, and a physical and cognitive examination was performed. The statistical analyses were carried out by independent sample t-test, chi-square, ANCOVA and logistic regression.
A co-morbidity score was significantly higher in AD participants compared to controls. The mean number of drugs was higher for AD participants compared to controls (5.1±3.6 and 2.9±2.4 respectively, p |
| doi_str_mv | 10.1186/1471-2318-11-58 |
| format | article |
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Nine rural municipalities with 70,000 inhabitants in Northern Norway.
PARTICIPANTS with and without AD recruited in general practice and by population based screening.187 participants with a recent diagnosis of AD were recruited among community dwellers. Of 791 respondents without cognitive symptoms, 500 were randomly selected and invited to further clinical and cognitive testing. The final control group consisted of 200 cognitively healthy individuals from the same municipalities. Demographic characteristics, data on medical history and current medication were included, and a physical and cognitive examination was performed. The statistical analyses were carried out by independent sample t-test, chi-square, ANCOVA and logistic regression.
A co-morbidity score was significantly higher in AD participants compared to controls. The mean number of drugs was higher for AD participants compared to controls (5.1±3.6 and 2.9±2.4 respectively, p<0.001 age and gender adjusted), also when adjusted for co-morbidity. AD participants used significantly more anticholinergic, sedative and antidepressant drugs. For nursing home residents with AD the mean number of drugs was significantly higher compared to AD participants living at home (6.9±3.9 and 4.5±3.3, respectively, p<0.001).
AD participants were treated with a significantly higher number of drugs as compared to cognitively healthy controls, even after adjustment for co-morbidity. An inappropriate use of anticholinergic and sedative drugs was identified, especially among nursing home residents with AD. The drug burden and the increased risk of adverse reactions among individuals suffering from AD need more attention from prescribing doctors.</description><identifier>ISSN: 1471-2318</identifier><identifier>EISSN: 1471-2318</identifier><identifier>DOI: 10.1186/1471-2318-11-58</identifier><identifier>PMID: 21970467</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; Aged, 80 and over ; Alzheimer Disease - drug therapy ; Alzheimer Disease - epidemiology ; Alzheimer's disease ; Angina pectoris ; Antidepressants ; Body mass index ; Cardiovascular disease ; Care and treatment ; Chronic illnesses ; Community medicine, Social medicine: 801 ; Comorbidity ; Confidence intervals ; Cross-Sectional Studies ; Dementia - drug therapy ; Dementia - epidemiology ; Diabetes ; Diagnosis ; Drug therapy ; Family medical history ; Family physicians ; Female ; Geriatrics ; Health sciences: 800 ; Helsefag: 800 ; Hospitals ; Humans ; Male ; Medical disciplines: 700 ; Medical/dental ethics, behavioural sciences, history: 805 ; Medicin och hälsovetenskap ; Medicine ; Medisinsk/odontologisk etikk, atferdsfag, historie: 805 ; Medisinske Fag: 700 ; Mental disorders ; Methods ; Morbidity ; Norway - epidemiology ; Older people ; Polypharmacy ; Population Surveillance - methods ; Prescription drugs ; Prescription Drugs - adverse effects ; Prescription Drugs - therapeutic use ; Psychotropic drugs ; Samfunnsmedisin, sosialmedisin: 801 ; Standard deviation ; Stroke ; Substance abuse treatment ; VDP</subject><ispartof>BMC geriatrics, 2011-10, Vol.11 (1), p.58-58, Article 58</ispartof><rights>COPYRIGHT 2011 BioMed Central Ltd.</rights><rights>2011 Andersen et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>info:eu-repo/semantics/openAccess</rights><rights>Copyright ©2011 Andersen et al; licensee BioMed Central Ltd. 2011 Andersen et al; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b722t-7bc29d0f6e19b0dfc09e22addb9dd0530b9713b391baa2b9d11ed9e75a97400f3</citedby><cites>FETCH-LOGICAL-b722t-7bc29d0f6e19b0dfc09e22addb9dd0530b9713b391baa2b9d11ed9e75a97400f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204237/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/902107776?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,26567,27924,27925,37012,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21970467$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:127072083$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Andersen, Fred</creatorcontrib><creatorcontrib>Viitanen, Matti</creatorcontrib><creatorcontrib>Halvorsen, Dag S</creatorcontrib><creatorcontrib>Straume, Bjørn</creatorcontrib><creatorcontrib>Engstad, Torgeir A</creatorcontrib><title>Co-morbidity and drug treatment in Alzheimer's disease. A cross sectional study of participants in the dementia study in northern Norway</title><title>BMC geriatrics</title><addtitle>BMC Geriatr</addtitle><description>Inappropriate medical treatment of co-morbidities in Alzheimer's disease (AD) is an increasing concern in geriatric medicine. The objective of this study was to compare current drug use related to co-morbidity between individuals with a recent diagnosis of AD and a cognitively healthy control group in a population based clinical trial in Northern Norway.
Nine rural municipalities with 70,000 inhabitants in Northern Norway.
PARTICIPANTS with and without AD recruited in general practice and by population based screening.187 participants with a recent diagnosis of AD were recruited among community dwellers. Of 791 respondents without cognitive symptoms, 500 were randomly selected and invited to further clinical and cognitive testing. The final control group consisted of 200 cognitively healthy individuals from the same municipalities. Demographic characteristics, data on medical history and current medication were included, and a physical and cognitive examination was performed. The statistical analyses were carried out by independent sample t-test, chi-square, ANCOVA and logistic regression.
A co-morbidity score was significantly higher in AD participants compared to controls. The mean number of drugs was higher for AD participants compared to controls (5.1±3.6 and 2.9±2.4 respectively, p<0.001 age and gender adjusted), also when adjusted for co-morbidity. AD participants used significantly more anticholinergic, sedative and antidepressant drugs. For nursing home residents with AD the mean number of drugs was significantly higher compared to AD participants living at home (6.9±3.9 and 4.5±3.3, respectively, p<0.001).
AD participants were treated with a significantly higher number of drugs as compared to cognitively healthy controls, even after adjustment for co-morbidity. An inappropriate use of anticholinergic and sedative drugs was identified, especially among nursing home residents with AD. The drug burden and the increased risk of adverse reactions among individuals suffering from AD need more attention from prescribing doctors.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alzheimer Disease - drug therapy</subject><subject>Alzheimer Disease - epidemiology</subject><subject>Alzheimer's disease</subject><subject>Angina pectoris</subject><subject>Antidepressants</subject><subject>Body mass index</subject><subject>Cardiovascular disease</subject><subject>Care and treatment</subject><subject>Chronic illnesses</subject><subject>Community medicine, Social medicine: 801</subject><subject>Comorbidity</subject><subject>Confidence intervals</subject><subject>Cross-Sectional Studies</subject><subject>Dementia - drug therapy</subject><subject>Dementia - epidemiology</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>Drug therapy</subject><subject>Family medical history</subject><subject>Family physicians</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Health sciences: 800</subject><subject>Helsefag: 800</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Medical disciplines: 700</subject><subject>Medical/dental ethics, behavioural sciences, history: 805</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine</subject><subject>Medisinsk/odontologisk etikk, atferdsfag, historie: 805</subject><subject>Medisinske Fag: 700</subject><subject>Mental disorders</subject><subject>Methods</subject><subject>Morbidity</subject><subject>Norway - epidemiology</subject><subject>Older people</subject><subject>Polypharmacy</subject><subject>Population Surveillance - methods</subject><subject>Prescription drugs</subject><subject>Prescription Drugs - adverse effects</subject><subject>Prescription Drugs - therapeutic use</subject><subject>Psychotropic drugs</subject><subject>Samfunnsmedisin, sosialmedisin: 801</subject><subject>Standard deviation</subject><subject>Stroke</subject><subject>Substance abuse treatment</subject><subject>VDP</subject><issn>1471-2318</issn><issn>1471-2318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>3HK</sourceid><sourceid>DOA</sourceid><recordid>eNp1kkuP0zAUhSMEYoaBNbuRBQtW6fiRxPEGqVQ8RhrBBtaWHzetSxMX22VUfgE_G2fSqabSoCiKde65X25uTlG8JnhGSNtckYqTkjLSloSUdfukOD8qTx-cz4oXMa4xJrylzfPijBLBcdXw8-Lvwpe9D9pZl_ZIDRbZsFuiFEClHoaE3IDmmz8rcD2EdxFZF0FFmKE5MsHHiCKY5PygNiimnd0j36GtCskZt1VDimN_WgGyMNKcOriyOviQC2FAX324VfuXxbNObSK8Ojwvih-fPn5ffClvvn2-XsxvSs0pTSXXhgqLuwaI0Nh2BgugVFmrhbW4ZlgLTphmgmilaBYJASuA10rwCuOOXRTXE9d6tZbb4HoV9tIrJ-8EH5bybvwNyFZj3OqGa153FeOVhk61BpTAtFbQQGaJiRVvYbvTJ7Rt8FYe9J9uvGUESSjHnOKW5d73U2829GBN3k5Qm1PESWVwK7n0vyWjuKKMZ8DlBDDBxeQGmReqJMGYcckErbLhw2TQzv_nDacV43s5RkaOkZGEyLrNkDeHMYP_tYOY5NrvQv7dUeY1EMw5b7Lp7WRaqrw2N3Q-80zvopFzyrOJMkqya_aIK185G874ATqX9ZOGq_svzEkL0B1nJ1iO8X9k2suHSz367_PO_gHCkQHR</recordid><startdate>20111004</startdate><enddate>20111004</enddate><creator>Andersen, Fred</creator><creator>Viitanen, Matti</creator><creator>Halvorsen, Dag S</creator><creator>Straume, Bjørn</creator><creator>Engstad, Torgeir A</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>3HK</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><scope>DOA</scope></search><sort><creationdate>20111004</creationdate><title>Co-morbidity and drug treatment in Alzheimer's disease. A cross sectional study of participants in the dementia study in northern Norway</title><author>Andersen, Fred ; Viitanen, Matti ; Halvorsen, Dag S ; Straume, Bjørn ; Engstad, Torgeir A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b722t-7bc29d0f6e19b0dfc09e22addb9dd0530b9713b391baa2b9d11ed9e75a97400f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alzheimer Disease - drug therapy</topic><topic>Alzheimer Disease - epidemiology</topic><topic>Alzheimer's disease</topic><topic>Angina pectoris</topic><topic>Antidepressants</topic><topic>Body mass index</topic><topic>Cardiovascular disease</topic><topic>Care and treatment</topic><topic>Chronic illnesses</topic><topic>Community medicine, Social medicine: 801</topic><topic>Comorbidity</topic><topic>Confidence intervals</topic><topic>Cross-Sectional Studies</topic><topic>Dementia - drug therapy</topic><topic>Dementia - epidemiology</topic><topic>Diabetes</topic><topic>Diagnosis</topic><topic>Drug therapy</topic><topic>Family medical history</topic><topic>Family physicians</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Health sciences: 800</topic><topic>Helsefag: 800</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Medical disciplines: 700</topic><topic>Medical/dental ethics, behavioural sciences, history: 805</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicine</topic><topic>Medisinsk/odontologisk etikk, atferdsfag, historie: 805</topic><topic>Medisinske Fag: 700</topic><topic>Mental disorders</topic><topic>Methods</topic><topic>Morbidity</topic><topic>Norway - epidemiology</topic><topic>Older people</topic><topic>Polypharmacy</topic><topic>Population Surveillance - methods</topic><topic>Prescription drugs</topic><topic>Prescription Drugs - adverse effects</topic><topic>Prescription Drugs - therapeutic use</topic><topic>Psychotropic drugs</topic><topic>Samfunnsmedisin, sosialmedisin: 801</topic><topic>Standard deviation</topic><topic>Stroke</topic><topic>Substance abuse treatment</topic><topic>VDP</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Andersen, Fred</creatorcontrib><creatorcontrib>Viitanen, Matti</creatorcontrib><creatorcontrib>Halvorsen, Dag S</creatorcontrib><creatorcontrib>Straume, Bjørn</creatorcontrib><creatorcontrib>Engstad, Torgeir A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>NORA - Norwegian Open Research Archives</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC geriatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Andersen, Fred</au><au>Viitanen, Matti</au><au>Halvorsen, Dag S</au><au>Straume, Bjørn</au><au>Engstad, Torgeir A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Co-morbidity and drug treatment in Alzheimer's disease. A cross sectional study of participants in the dementia study in northern Norway</atitle><jtitle>BMC geriatrics</jtitle><addtitle>BMC Geriatr</addtitle><date>2011-10-04</date><risdate>2011</risdate><volume>11</volume><issue>1</issue><spage>58</spage><epage>58</epage><pages>58-58</pages><artnum>58</artnum><issn>1471-2318</issn><eissn>1471-2318</eissn><abstract>Inappropriate medical treatment of co-morbidities in Alzheimer's disease (AD) is an increasing concern in geriatric medicine. The objective of this study was to compare current drug use related to co-morbidity between individuals with a recent diagnosis of AD and a cognitively healthy control group in a population based clinical trial in Northern Norway.
Nine rural municipalities with 70,000 inhabitants in Northern Norway.
PARTICIPANTS with and without AD recruited in general practice and by population based screening.187 participants with a recent diagnosis of AD were recruited among community dwellers. Of 791 respondents without cognitive symptoms, 500 were randomly selected and invited to further clinical and cognitive testing. The final control group consisted of 200 cognitively healthy individuals from the same municipalities. Demographic characteristics, data on medical history and current medication were included, and a physical and cognitive examination was performed. The statistical analyses were carried out by independent sample t-test, chi-square, ANCOVA and logistic regression.
A co-morbidity score was significantly higher in AD participants compared to controls. The mean number of drugs was higher for AD participants compared to controls (5.1±3.6 and 2.9±2.4 respectively, p<0.001 age and gender adjusted), also when adjusted for co-morbidity. AD participants used significantly more anticholinergic, sedative and antidepressant drugs. For nursing home residents with AD the mean number of drugs was significantly higher compared to AD participants living at home (6.9±3.9 and 4.5±3.3, respectively, p<0.001).
AD participants were treated with a significantly higher number of drugs as compared to cognitively healthy controls, even after adjustment for co-morbidity. An inappropriate use of anticholinergic and sedative drugs was identified, especially among nursing home residents with AD. The drug burden and the increased risk of adverse reactions among individuals suffering from AD need more attention from prescribing doctors.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>21970467</pmid><doi>10.1186/1471-2318-11-58</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC geriatrics, 2011-10, Vol.11 (1), p.58-58, Article 58 |
| issn | 1471-2318 1471-2318 |
| language | eng |
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| source | PubMed Central Free; NORA - Norwegian Open Research Archives; Publicly Available Content Database |
| subjects | Aged Aged, 80 and over Alzheimer Disease - drug therapy Alzheimer Disease - epidemiology Alzheimer's disease Angina pectoris Antidepressants Body mass index Cardiovascular disease Care and treatment Chronic illnesses Community medicine, Social medicine: 801 Comorbidity Confidence intervals Cross-Sectional Studies Dementia - drug therapy Dementia - epidemiology Diabetes Diagnosis Drug therapy Family medical history Family physicians Female Geriatrics Health sciences: 800 Helsefag: 800 Hospitals Humans Male Medical disciplines: 700 Medical/dental ethics, behavioural sciences, history: 805 Medicin och hälsovetenskap Medicine Medisinsk/odontologisk etikk, atferdsfag, historie: 805 Medisinske Fag: 700 Mental disorders Methods Morbidity Norway - epidemiology Older people Polypharmacy Population Surveillance - methods Prescription drugs Prescription Drugs - adverse effects Prescription Drugs - therapeutic use Psychotropic drugs Samfunnsmedisin, sosialmedisin: 801 Standard deviation Stroke Substance abuse treatment VDP |
| title | Co-morbidity and drug treatment in Alzheimer's disease. A cross sectional study of participants in the dementia study in northern Norway |
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