Hostname: page-component-745bb68f8f-g4j75 Total loading time: 0 Render date: 2025-01-23T20:45:53.422Z Has data issue: false hasContentIssue false
  • English
  • Français

Less Education Predicts Anticholinesterase Discontinuation in Dementia Patients

Published online by Cambridge University Press:  23 September 2014

Solin Saleh ,
Andrew Kirk ,
Debra G. Morgan  and
Chandima Karunanayake
Solin Saleh*
Affiliation:
College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Andrew Kirk
Affiliation:
Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Debra G. Morgan
Affiliation:
Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Chandima Karunanayake
Affiliation:
Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
*
College of Medicine, University of Saskatchewan, 5D40 Health Sciences building, 107 Wiggins Road, Saskatoon SK, S7N 5E5, Canada. email: [email protected]
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

We investigated patient socio-demographic, clinical and functional factors predicting cholinesterase inhibitor discontinuation by patients presenting to a memory clinic in Saskatoon, Saskatchewan.

Methods:

Data collection began in March 2004 at the Rural and Remote Memory Clinic where family physicians referred their non-institutionalized patients. Neurological and neuropsychological assessment, patient and caregiver questionnaires provided the socio-demographic, clinical and functional variables. Univariate logistic regression analysis was used to examine possible associations between each independent variable and the binary outcome variable of treatment discontinuation. Multivariate logistic regression was used to determine predictors of cholinesterase inhibitor discontinuation within six months of drug initiation.

Results:

Our sample consisted of the first 63 patients (60.3% female) for whom we prescribed a cholinesterase inhibitor. The mean age at clinic day was 74.56 years (SD=7.78). We found that years of formal education was the only variable significantly associated with cholinesterase inhibitor discontinuation by six months. The more years of formal education, the lower the rate of drug discontinuation by six months.

Conclusions:

Likelihood of cholinesterase inhibitor discontinuation by six months was predicted by fewer years of formal education.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 5 , September 2013 , pp. 684 - 690
Copyright
Copyright © The Canadian Journal of Neurological 2013

References

1.Alzheimer Society of Canada. Rising tide: the impact of dementia on Canadian society executive summary; 2010.Google Scholar
2.Hogan, DB, Patterson, C.Progress in clinical neurosciences: Treatment of Alzheimer's disease and other dementias-review and comparison of the cholinesterase inhibitors. Can J Neurol Sci. 2002;29:306–14.CrossRefGoogle ScholarPubMed
3.Amuah, JE, Hogan, DB, Eliasziw, M, et al.Persistence with cholinesterase inhibitor therapy in a population-based cohort of patients with Alzheimer's disease. Pharmacoepidemiol Drug Saf. 2010;19:670–9.Google Scholar
4.Elliot (b). Special tabulation by Sask trends Monitor (2012) from Statistics Canada 2011 data. Sask trends Monitor. Regina, SK. Available from: http://www.sasktrends.ca.Google Scholar
5.Elliot (a). The age distribution of the Saskatchewan population. Sask Trends Monitor. May 2012;24:2-10.Google Scholar
6.Morgan, DG, Crossley, M, Kirk, A, et al.Improving access to dementia care: development and evaluation of a rural and remote memory clinic. Aging Ment Health. 2009;13:17–30.Google Scholar
7.Morgan, DG, Crossley, M, Kirk, A, et al.Evaluation of telehealth for preclinic assessment and follow-up in an interprofessional rural and remote memory clinic. J Appl Gerontol. 2011;30:304–31.Google Scholar
8.Lacny, C, Kirk, A, Morgan, DG, Karunanayake, C.Does day length affect cognitive performance in memory clinic patients? Can J Neurol Sci. 2011;38:461–4.CrossRefGoogle ScholarPubMed
9.Steve, T, Kirk, A, Crossley, M, et al.Medication use in patients presenting to a rural and remote memory clinic. Can J Neurol Sci. 2008;35:669–71.Google Scholar
10.Umegaki, H, Itoh, A, Suzuki, Y, Nabeshima, T.Discontinuation of donepezil for the treatment of Alzheimer's disease in geriatric practice. Int Psychogeriatr. 2008;20:800–6.Google Scholar
11.Pfeffer, R, Kurosaki, T, Harrah, C, Chance, J, Filos, S.Measurement of functional activities in older adults in the community. J Gerontol. 1982;37:323–9.Google Scholar
12.Cummings, J, Mega, M, Gray, K, Rosenberg-Thompson, S, Carusi, DA, Gornbein, J.The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994; 44:2308–14.Google Scholar
13.Bucks, RS, Ashworth, DL, Wilcock, GK, Siegfried, K.Assessment of activities of daily living in dementia: development of the Bristol activities of daily living scale. Age Ageing. 1996;25:113–20.Google Scholar
14.Logsdon, RG, Gibbons, LE, McCurry, SM, Teri, L.Quality of life in Alzheimer's disease: patient and caregiver reports. J Ment Health Aging. 1999;5:21–32.Google Scholar
15.Radloff, LS.The CES-D Scale: a self-report depression scale for research in the general population. Appl Psych Meas. 1977;1:385–401.Google Scholar
16.Lawton, MP, Brody, EM.Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;3:179–86.Google Scholar
17.Squire, Zouzounis. Self-ratings of memory dysfunction: different findings in depression and amnesia. JCEN. 1988;10:727–38.CrossRefGoogle ScholarPubMed
18.Abughosh, SM, Kogut, SJ.Comparison of persistence rates of acetylcholine-esterase inhibitors in a state Medicaid program. Patient Prefer Adher. 2008;2:79–85.Google Scholar
19.Herrmann, N, Binder, C, Dalziel, W, Smyth, S, Camacho, F.Persistence with cholinesterase inhibitor therapy for dementia: an observational administrative health database study. Drugs Aging. 2009;26:403–7.CrossRefGoogle ScholarPubMed
20.Kroger, E, Van Marum, R, Souverein, P, Egberts, T.Discontinuation of cholinesterase inhibitor treatment and determinants thereof in the Netherlands: a retrospective cohort study. Drugs Aging. 2010;27:663–75.Google Scholar
21.Farlow, M, Veloso, F, Moline, M, et al.Safety and tolerability of donepezil 23 mg in moderate to severe Alzheimer's disease. BMC Neurol. 2011;25:57.Google Scholar
22.Massoud, F, Desmarais, JE, Gauthier, S.Switching cholinesterase inhibitors in older adults with dementia. Int Psychogeriatr. 2011;23:372–8.CrossRefGoogle ScholarPubMed
23.Herrman, N, Black, SE, Li, A, Lanctot, KL.Discontinuing cholinesterase inhibitors: results of a survey of Canadian dementia experts. Int Psychogeriatr. 2011;23:539–45.Google Scholar
24.Pariente, A, Pinet, M, Moride, Y, Merliere, Y, Moore, N, Fourrier-Reglat, A.Factors associated with persistence of cholinesterase inhibitor treatments in the elderly. Pharmacoepidemiol Drug Saf. 2010;19:680–6.Google Scholar
25.Government of Saskatchewan Ministry of Health. (2012). Drug Plan Overview: Appendix A. Retrieved from Saskatchewan Formulary website: Available from: http://formulary.drugplan.health.gov.sk.ca/publications/APPENDIX%20A.pdfGoogle Scholar