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Medication use patterns among demented, cognitively impaired and cognitively intact community-dwelling elderly people. 1998

K E Schmader, and J T Hanlon, and G G Fillenbaum, and M Huber, and C Pieper, and R Horner
Center for the Study of Aging and Human Development, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.

OBJECTIVE To determine whether medication use patterns in community-dwelling elderly people vary with level of cognitive function-dementia, cognitive impairment (but not dementia) and intact cognition. METHODS Cross-sectional survey. METHODS A five-county area of central North Carolina, USA. METHODS 520 members of the Duke Established Populations for Epidemiologic Studies of the Elderly. METHODS Medication use in the previous 2 weeks was ascertained during a interview in the patient's home and was coded as to prescription and therapeutic class status. Cognitive status, the primary independent variable, was divided into: (i) dementia (n=100); (ii) cognitive impairment but not dementia (n=117); and (iii) cognitively intact (n=303). The dependent variables were any prescription or over-the-counter (OTC) medication use (vs non-use); number of prescription or OTC medications used; and prescription and OTC use combined within major therapeutic classes. Multivariate analyses controlled for socio-demographic characteristics, health status, functional status and access to health care. RESULTS The use of any prescription medication was similar in the three groups. The demented were significantly less likely than cognitively impaired people to use any OTC medications (OR=0.65, 95% CI=0.45, 0.93), cardiovascular medications (OR=0.70, 95% CI=0.49, 0.99) and analgesics (OR=0.54, 95% CI=0.39, 0.75). As a combined group, those who were demented and cognitively impaired were less likely than the cognitively intact group to use any OTC medications (OR=0.78, 95% CI 0.65, 0.92). Compared with the cognitively impaired subjects, the demented group took fewer prescription medications (beta coefficient=-0.31, 95% CI=-0.59, -0.03) and similar numbers of OTC medications. Compared with those who were cognitively intact, the combined group of demented and cognitively impaired subjects took fewer OTC medications (beta coefficient=-0.14, 95% CI=-0.23, -0.05) and similar numbers of prescription medications. CONCLUSIONS Increasing level of cognitive dysfunction is associated with decreased use of OTC, cardiovascular and analgesic medications and the use of fewer prescription medications. These results suggest important differences in medication use patterns among community-dwelling elderly people who vary in cognitive status.

UI MeSH Term Description Entries
D008297 Male Males
D009657 North Carolina State bounded on the north by Virginia, on the east and Southeast by the Atlantic Ocean, on the south by Georgia and South Carolina, and on the west by Tennessee.
D011307 Drug Prescriptions Directions written for the obtaining and use of DRUGS. Drug Prescribing,Drug Prescription,Drug Prescribings,Prescribing, Drug,Prescribings, Drug
D003072 Cognition Disorders Disorders characterized by disturbances in mental processes related to learning, thinking, reasoning, and judgment. Overinclusion,Disorder, Cognition,Disorders, Cognition
D003625 Data Collection Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. Data Collection Methods,Dual Data Collection,Collection Method, Data,Collection Methods, Data,Collection, Data,Collection, Dual Data,Data Collection Method,Method, Data Collection,Methods, Data Collection
D003704 Dementia An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. Senile Paranoid Dementia,Amentia,Familial Dementia,Amentias,Dementia, Familial,Dementias,Dementias, Familial,Dementias, Senile Paranoid,Familial Dementias,Paranoid Dementia, Senile,Paranoid Dementias, Senile,Senile Paranoid Dementias
D004363 Drug Utilization The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles. Utilization, Drug,Drug Utilizations,Utilizations, Drug
D004366 Nonprescription Drugs Medicines that can be sold legally without a DRUG PRESCRIPTION. Drugs, Non-Prescription,Non-Prescription Drug,Nonprescription Drug,OTC Drug,OTC Drugs,Over-the-Counter Drug,Over-the-Counter Drugs,Patent Medicine,Patent Medicines,Drugs, Nonprescription,Medicines, Patent,Non-Prescription Drugs,Drug, Non-Prescription,Drug, Nonprescription,Drug, OTC,Drug, Over-the-Counter,Drugs, Non Prescription,Drugs, OTC,Drugs, Over-the-Counter,Medicine, Patent,Non Prescription Drug,Non Prescription Drugs,Over the Counter Drug,Over the Counter Drugs
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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