Cholinesterase Inhibitor Use in US Nursing Homes: Results from the National Nursing Home Survey
Cholinesterase Inhibitor Use in US Nursing Homes: Results from the National Nursing Home Survey
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DOI：
10.1111/j.1532-5415.2009.02552.x
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发表时间：
2009-12-01
影响因子：
6.3
通讯作者：
Rochon, Paula A.
中科院分区：
文献类型：
--
作者：
Seitz, Dallas P.;Gruneir, Andrea;Rochon, Paula A.
目标：确定老年痴呆疗养院（NH）居民使用胆碱酯酶抑制剂（ChEI）的频率，并检查该人群使用ChEI的相关性。设计：采用2004年全国疗养院调查（NNHS）的横断面研究。设置：美国NHs.Participants的代表性，分层，随机样本。所有NNHS参与者年龄在65岁及以上，诊断为痴呆。测量：双变量分析比较的NH居民与痴呆症的特征，根据ChEI状态和多变量Logistic回归，以确定独立的相关ChEI use.Results：几乎一半（49.1%）的NNHS参与者痴呆症，和30.0%的痴呆症患者接受ChEI。多奈哌齐占所有ChEI处方的71%。多变量logistic回归分析显示，ChEI的使用与年轻年龄独立相关（比值比（OR）= 0.42，95%置信区间（CI）= 0.28-0.64，年龄>= 95岁vs 65-74岁），日常生活能力受损较少（OR = 0.49，95% CI = 0.42-0.58，重度vs轻度损害），更多使用抗精神病药物（OR=1.33，95%CI =1.16-1.54）和抗抑郁药（OR = 1.38，95%CI = 1.20-1.59），以及居住在床位较多的NHs-OR = 1.52，95%CI = 1.07-2.16，200张床位以上vs
OBJECTTVES: To determine the frequency of cholinesterase inhibitor (ChEI) use in nursing home (NH) residents with dementia and examine correlates of ChEI use in this population.DESIGN: Cross-sectional study using the 2004 National Nursing Home Survey (NNHS).SETTING: A representative, stratified, random sample of U.S. NHs.PARTICIPANTS: All NNHS participants aged 65 and older with a chart diagnosis of dementia.MEASUREMENTS: Bivariate analyses to compare characteristics of NH residents with dementia according to ChEIs status and multivariable logistic regression to identify independent correlates of ChEI use.RESULTS: Almost half (49.1%) of NNHS participants had dementia, and 30.0% of those with dementia were receiving ChEIs. Donepezil accounted for 71% of all ChEI prescriptions. Multivariable logistic regression showed that ChEI use was independently associated with younger age (odds ratio (OR) = 0.42, 95% confidence interval (CI) = 0.28-0.64, aged >= 95 vs 65-74), less activity of daily living impairment (OR = 0.49, 95% CI = 0.42-0.58, severe vs mild impairment), greater use of antipsychotics (OR=1.33, 95% CI=1.16-1.54) and antidepressants (OR = 1.38, 95% CI = 1.20-1.59), and residence in NHs with more beds (OR = 1.52, 95% CI = 1.07-2.16, >= 200 beds vs