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Changes in Medication Use After Dementia Diagnosis in an Observational Cohort of Individuals with Diabetes Mellitus.

Abstract：

OBJECTIVES:To assess changes in medication use after a diagnosis of dementia in individuals with type 2 diabetes mellitus. DESIGN:Difference-in-differences analysis of changes in the number of dispensed chronic medications between individuals with and without newly diagnosed dementia. SETTING:Integrated healthcare delivery system, Kaiser Permanente Northern California. PARTICIPANTS:Individuals aged 50 and older without prevalent dementia with type 2 diabetes mellitus enrolled in a baseline survey. During 5 years of follow-up, 193 individuals with a new diagnosis of dementia were identified, and risk-set sampling was used to randomly select five reference subjects per case matched on 5-year age categories and sex (965 matched participants), resulting in an analytical sample of 1,158. MEASUREMENTS:The exposure was new diagnosis of dementia. The primary outcome was change in number of current chronic medications (total, cardiovascular (blood pressure and lipid control), diabetes mellitus) at three times: 1 year before index date (preindex date), date of diagnosis of dementia or matched reference date (index date), and up to 1 year after index date or end of follow-up if censored before 1 year (postindex date). RESULTS:After adjustment, the number of chronic medications and the subset of cardiovascular medications declined after a dementia diagnosis in the overall cohort and in age-, sex-, and time-matched reference individuals, but the decline was significantly greater in the group with dementia (0.71 medications fewer than the reference group, P = .02). The number of diabetes mellitus medications declined in both groups, but the declines were not statistically different (0.18 medications fewer than the reference group, P = .008). CONCLUSIONS:Use of cardiometabolic medications fell after a diagnosis of dementia, as recommended in national guidelines.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Sarkar U,Lyles C,Steinman M,Huang ES,Moffet HH,Whitmer RA,Warton EM,Karter AJ

doi

10.1111/jgs.14429

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

77-82

issue

eissn

0002-8614

issn

1532-5415

journal_volume

pub_type

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Changes in Medication Use After Dementia Diagnosis in an Observational Cohort of Individuals with Diabetes Mellitus.