Education and use of dementia drugs: a register-based study of over 600,000 older people.

BACKGROUND/AIMS: Low education has been shown to be a risk factor for dementia. However, little is known about the association between educational level and dementia drugs.

METHODS

We conducted a register-based study in Sweden of 645,973 people aged 75-89 years. Data on age, sex, type of residential area (urban/rural), dispensed drugs and education were analyzed from people aged 75-89 years registered in the Swedish Prescribed Drug Register during July to October 2005. The 3 main outcome measures were dispensed dementia drugs, cholinesterase inhibitors (donepezil, rivastigmine and galantamine) and memantine.

RESULTS

Dementia drugs were used by 3% of the study population, cholinesterase inhibitors by almost 3% and memantine by 0.4%. High education was associated with dementia drugs (OR: 1.26; 95% CI: 1.19-1.34 for >or=15 years of education compared with <or=9 years), cholinesterase inhibitors (OR: 1.25; 95% CI: 1.17-1.33 for >or=15 years of education compared with <or=9 years) and, especially, memantine (OR: 1.46; 95% CI: 1.26-1.68 for >or=15 years of education compared with <or=9 years), after adjustment for age, sex, type of residential area and number of dispensed drugs.

CONCLUSION

The results indicate that there may be inequalities in the use of dementia drugs among elderly Swedes. Future research is required to explain why educational level has the opposite relationship to dementia drugs than to dementia diagnosis.