Department of Mental Health Sciences (Archway campus), University College London, Highgate Hill, London N19 5NL, UK.
Aging Ment Health. 2010 Jan;14(1):85-9. doi: 10.1080/13607860902918256.
We aimed to investigate for the first time whether cholinesterase inhibitor prescription was associated with economic status in a population of people with dementia.
We recruited 215 people with dementia, living independently, who were consecutively referred to five Community Mental Health Teams in London and Essex. We tested our hypothesis that home owners were more likely to be prescribed cholinesterase inhibitors than those who rented their accommodation.
People who owned their home were four times more likely to be prescribed cholinesterase inhibitors (OR 4.2, 1.8-9.8; p = 0.001). Younger age, fewer neuropsychiatric symptoms, having a dementia diagnosis for which cholinesterase inhibitors were recommended and longer time since diagnosis also predicted prescription, but severity of cognitive impairment did not.
Despite high-profile guidelines that NHS cholinesterase prescribing should be restricted to people with moderate dementia, being a home owner was a strong predictor of prescription, while dementia severity was not. We recommend that health services should be audited to ensure that access to treatment increases in those who are socioeconomically disadvantaged.
我们旨在首次探究在痴呆人群中，是否存在抗胆碱酯酶抑制剂的处方与经济状况有关。
我们招募了 215 名独立生活的痴呆患者，他们连续被转介到伦敦和埃塞克斯的五家社区心理健康团队。我们检验了我们的假设，即房主比租房者更有可能被开抗胆碱酯酶抑制剂。
拥有房产的人更有可能被开抗胆碱酯酶抑制剂（OR 4.2，1.8-9.8；p = 0.001）。年龄较小、神经精神症状较少、患有推荐使用抗胆碱酯酶抑制剂的痴呆症诊断以及诊断后时间较长也预测了处方，但认知障碍的严重程度没有预测到。
尽管有明确的 NHS 抗胆碱酯酶药物使用指南，规定只应将其用于中度痴呆患者，但拥有房产是处方的一个强有力的预测因素，而痴呆症的严重程度不是。我们建议对卫生服务进行审核，以确保在社会经济处于不利地位的人群中增加治疗机会。
