Abstract:
OBJECTIVES:To examine current utilization patterns of cholinesterase inhibitor (ChEI) therapy for dementia to determine treatment duration, use in long-term care, how often patients receive these drugs until death, and frequency of switching between the available ChEIs. DESIGN:A population-based healthcare administrative database study. SETTING:Patients aged 66 and older from the Canadian province of Ontario who received a new prescription for a ChEI between June 1, 2000, and December 31, 2002. Patients were followed until discontinuation of ChEI therapy, death, or end of the observation period (March 31, 2005). PARTICIPANTS:Twenty-eight thousand nine hundred and sixty-one patients, including 4,601 residing in long-term care, mean age 80, 63% female. MEASUREMENTS:Information on diagnosis, medical comorbidity, physician visits, and concomitant medication use was obtained. Estimates of duration of continuous use were determined. The percentage of patients who remained on the initial dose prescribed, the proportion who switched to a second ChEI, and the percentage who remained on ChEIs until death were calculated. RESULTS:Patients had on average more than 26 physician visits in the year before ChEI therapy, but only 28% had seen a dementia specialist. Concomitant use of potentially inappropriate medications (strongly anticholinergic medications and benzodiazepines) was noted in 37% of patients. The average length of treatment for all patients was 866 days. Many patients (43%) remained on the initial dose prescribed, 6% switched to another ChEI, and 19% died while on ChEI therapy. CONCLUSION:Elderly patients with dementia are treated for lengthy periods of time with ChEIs in the community and in long-term care facilities. Further research is required to determine whether these utilization patterns are appropriate. It is also unclear whether these results are generalizable to other populations without universal health coverage or drug formulary benefits.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Herrmann N,Gill SS,Bell CM,Anderson GM,Bronskill SE,Shulman KI,Fischer HD,Sykora K,Shi HS,Rochon PAdoi
10.1111/j.1532-5415.2007.01377.xsubject
Has Abstractpub_date
2007-10-01 00:00:00pages
1517-23issue
10eissn
0002-8614issn
1532-5415pii
JGS1377journal_volume
55pub_type
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journal_title:Journal of the American Geriatrics Society
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abstract::The relative merits of the hospice, palliative care units, and geriatrics departments as settings for management of the dying patient are considered. ...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1983.tb02203.x
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abstract::The stage of a cancer at diagnosis is multiply determined, theoretically depending on such disparate factors as tumor biology, patient education, and physician behaviors. Data from all Hispanic and non-Hispanic white residents of New Mexico diagnosed with a malignancy from 1969 through 1982 were analyzed to determine ...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1986.tb06335.x
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abstract::The influence of aging on serum levels of gonadotropins (FSH and LH), testosterone and estradiol was studied in the following groups: 4 normal men (ages 30 to 50), 38 men with symptoms of the male climacteric (ages 51 to 84), 25 men with relative impotence (ages 31 to 50), 10 normal women (ages 24 to 31), and 6 menopa...
journal_title:Journal of the American Geriatrics Society
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1980.tb00205.x
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To determine how physical activity at various ages over the life course is associated with cognitive impairment in late life. DESIGN:Cross-sectional study. SETTING:Four U.S. sites. PARTICIPANTS:Nine thousand three hundred forty-four women aged 65 and older (mean 71.6) who self-reported teenage, age 30, age...
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更新日期:2010-07-01 00:00:00
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更新日期:2000-12-01 00:00:00
abstract:OBJECTIVES:To investigate the effectiveness of an exercise program in improving ability to perform activities of daily living (ADLs), physical performance, and nutritional status and decreasing behavioral disturbance and depression in patients with Alzheimer's disease (AD). DESIGN:Randomized, controlled trial. SETTIN...
journal_title:Journal of the American Geriatrics Society
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更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:To investigate the correlation between zopiclone use and risk of hip fracture in elderly adults. DESIGN:Case-control study. SETTING:Claim data from the Taiwan National Health Insurance Program. PARTICIPANTS:Individuals aged 65 and older who experienced their first episode of hip fracture between 1998 and ...
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更新日期:2015-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb01480.x
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVES:To describe the association between frailty and health status, the progression of frailty, and the relationship between frailty and mortality in older men. DESIGN:Cross-sectional and prospective cohort study. SETTING:Six U.S. clinical centers. PARTICIPANTS:Five thousand nine hundred ninety-three community...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2007.01259.x
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:To describe the composition of the US provider workforce for adults with cancer older than 65 years and to determine whether there were differences in patients who received care from different providers (eg, nurse practitioners [NPs], physician assistants [PAs], and specialty physicians). DESIGN:Observation...
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doi:10.1111/jgs.15931
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:To assess clinical outcomes and identify risk factors for mortality in older adults with Staphylococcus aureus bloodstream infection (SAB). DESIGN:Retrospective review. SETTING:University of Michigan Health System, Ann Arbor. PARTICIPANTS:All patients aged 80 and older with SAB between January 2004 and Ju...
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doi:10.1111/j.1532-5415.2009.02666.x
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES:To examine the neuropsychological and clinical profile of help-seekers in an early-detection community dementia program and to explore any relationship between profiles and time to seek help. DESIGN:Cross-sectional. SETTING:Early-detection community dementia program. PARTICIPANTS:Help-seekers (N = 1,005) ...
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pub_type: 杂志文章
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更新日期:2016-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb01672.x
更新日期:1979-09-01 00:00:00
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doi:10.1111/j.1532-5415.1977.tb00648.x
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更新日期:2020-10-31 00:00:00
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更新日期:2017-03-01 00:00:00
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更新日期:1996-02-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence and outcomes of breathlessness in older Americans. SETTING:Community-dwelling older adults. PARTICIPANTS:Individuals aged 70 and older in the nationally representative Health and Retirement Study (2008, follow-up through 2012) (N = 3,671; mean age 78). MEASUREMENTS:Breathlessne...
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更新日期:2016-10-01 00:00:00
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更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of dental problems in Paget's patients and in a control population without Paget's disease. The relationship of localization of bony involvement of Paget's disease with the prevalence of dental, auditory, visual, and smell changes is examined. DESIGN:Cross-sectional national surve...
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pub_type: 杂志文章
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更新日期:1995-12-01 00:00:00
abstract:OBJECTIVES:To assess 1-week prevalence of International Classification of Disease, Tenth Edition (ICD-10) current depression, physical comorbidity, associated disability, and healthcare utilization in older primary care patients. Comparisons with younger patients are also reported. DESIGN:Cross-sectional, two-phase ep...
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更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To describe the differences between healthy young and older women in regards to trunk elevation and hip pivot motions when rising from a supine to a seated position. DESIGN:Cross-sectional comparison. SETTING:University laboratory. PARTICIPANTS:Two groups of healthy female volunteers: young adult female co...
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pub_type: 杂志文章
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更新日期:1995-04-01 00:00:00