Johnell Kristina, Weitoft Gunilla Ringbäck, Fastbom Johan
Aging Research Centre, Karolinska Institutet, Stockholm, Sweden.
Dement Geriatr Cogn Disord. 2008;25(1):54-9. doi: 10.1159/000111534. Epub 2007 Nov 23.
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.
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.
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.
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.
背景/目的：低教育水平已被证明是痴呆症的一个风险因素。然而，关于教育水平与痴呆症药物之间的关联却知之甚少。
我们在瑞典对645973名75 - 89岁的人群进行了一项基于登记册的研究。分析了2005年7月至10月在瑞典处方药登记册中登记的75 - 89岁人群的年龄、性别、居住地区类型（城市/农村）、所配药物和教育程度数据。3个主要结局指标是所配的痴呆症药物、胆碱酯酶抑制剂（多奈哌齐、卡巴拉汀和加兰他敏）和美金刚。
3%的研究人群使用了痴呆症药物，近3%使用了胆碱酯酶抑制剂，0.4%使用了美金刚。在对年龄、性别、居住地区类型和所配药物数量进行调整后，高教育水平与痴呆症药物（教育年限≥15年与≤9年相比，比值比：1.26；95%置信区间：1.19 - 1.34）、胆碱酯酶抑制剂（教育年限≥15年与≤9年相比，比值比：1.25；95%置信区间：1.17 - 1.33），尤其是美金刚（教育年限≥15年与≤9年相比，比值比：1.46；95%置信区间：1.26 - 1.68）相关。
结果表明瑞典老年人在痴呆症药物使用方面可能存在不平等现象。需要未来的研究来解释为什么教育水平与痴呆症药物的关系与痴呆症诊断的关系相反。
