Co-morbidity and drug treatment in Alzheimer's disease. A cross sectional study of participants in the dementia study in northern Norway.
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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DOI：
10.1186/1471-2318-11-58
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发表时间：
2011-10-04
期刊：
影响因子：
4.1
通讯作者：
Engstad TA
中科院分区：
文献类型：
--
作者：
Andersen F;Viitanen M;Halvorsen DS;Straume B;Engstad TA
阿尔茨海默病（AD）合并症的不适当的药物治疗是老年医学中日益关注的问题。本研究的目的是在挪威北方的一项基于人群的临床试验中，比较近期诊断为AD的个体与认知健康对照组之间与合并症相关的当前药物使用情况。背景：挪威北方9个农村自治市，70 000名居民。参与者：在全科实践中招募的和通过基于人群的筛查招募的AD患者和非AD患者。在社区居民中招募了187名最近诊断为AD的参与者。在791名没有认知症状的受访者中，随机选择了500人，并邀请他们进行进一步的临床和认知测试。最后的对照组由来自同一城市的200名认知健康的人组成。纳入人口统计学特征、病史和当前用药数据，并进行体格和认知检查。采用独立样本t检验、卡方检验、协方差分析和Logistic回归进行统计学分析。与对照组相比，AD参与者的共病评分显著较高。与对照组相比，AD参与者的平均药物数量更高（分别为5.1 ± 3.6和2.9 ± 2.4，p < 0.001，年龄和性别调整），也是在调整合并症时。AD参与者使用更多的抗胆碱能药物，镇静剂和抗抑郁药。对于患有AD的疗养院居民，药物的平均数量显著高于居住在家中的AD参与者（分别为6.9 ± 3.9和4.5 ± 3.3，p < 0.001）。与认知健康的对照组相比，AD参与者接受了显着更高数量的药物治疗，即使在调整合并症后。抗胆碱能和镇静药物的不适当使用被确定，特别是在养老院居民与AD。AD患者的药物负担和不良反应风险增加需要处方医生给予更多关注。
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. Setting: Nine rural municipalities with 70 000 inhabitants in Northern Norway. Participants: 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.
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影响因子：
6.7
作者：
Deschenes, Cynthia L.;McCurry, Susan M.
通讯作者：
McCurry, Susan M.
影响因子：
5.4
作者：
Barnett, K.;McCowan, C.;Fahey, T.
通讯作者：
Fahey, T.
影响因子：
3.6
作者：
Ferrara, Maria;Langiano, Elisa;Bauco, Claudia
通讯作者：
Bauco, Claudia
DOI：
10.1111/j.1532-5415.2008.01741.x
发表时间：
2008-07-01
影响因子：
6.3
作者：
Holmes, Holly M.;Sachs, Greg A.;Dale, William
通讯作者：
Dale, William
影响因子：
4
作者：
Andersen, Fred;Engstad, Torgeir A.;Sjobrend, Kjell
通讯作者：
Sjobrend, Kjell