Alghamdi Ali, de Vos Stijn, Bos Jens Hj, Schuiling-Veninga Catharina Cm, van Munster Barbara C, Mubarik Sumaira, Luijendijk Hendrika J, Hak Eelko
Groningen Research Institute of Pharmacy, PharmacoTherapy, Epidemiology & Economics, University of Groningen, Groningen, The Netherlands.
Department of Geriatric Medicine, University Medical Center of Groningen, University of Groningen, Groningen, The Netherlands.
J Alzheimers Dis. 2025 Feb;103(3):706-713. doi: 10.1177/13872877241305799. Epub 2025 Jan 10.
Alzheimer's disease (AD) is the most prevalent form of dementia, characterized by amyloid-β plaques and neurofibrillary tangles. With an aging population, both AD and comorbidities are increasingly common. Managing comorbidities often requires multiple medications, leading to polypharmacy, defined as the concurrent use of five or more medications.
This study aimed to estimate and compare the prevalence of polypharmacy one-year prior AD diagnosis compared to non-AD individuals. A matched cross-sectional design used data from the IADB.nl prescription database (1994-2021), including individuals aged 65 and older with at least one AD medication prescription within a year. Controls were matched by age and sex at a 9:1 ratio. Analyses were stratified by time period (≤2010 and >2010) and further by sex and age.
4150 AD individuals were included and matched with 37,350 controls. AD individuals had a higher prevalence of polypharmacy compared to controls, ≤ 2010 (OR: 1.15, 95% CI: 1.03-1.29), > 2010 (OR: 1.25, 95% CI: 1.16-1.36). Females with AD had slightly higher odds of polypharmacy than males. The prevalence was consistent across different time periods and age groups, with the highest odds in individuals aged 65-74.
AD individuals in the Netherlands exhibit a significantly higher prevalence of polypharmacy in a year pre-AD diagnosis. The findings highlight the complexity of managing multiple comorbid conditions in AD individuals, emphasizing the need for regular review and optimization of medication regimens and the inclusion of non-pharmacological interventions to minimize adverse outcomes and improve quality of life.
阿尔茨海默病（AD）是最常见的痴呆形式，其特征为β淀粉样蛋白斑块和神经原纤维缠结。随着人口老龄化，AD和合并症越来越普遍。管理合并症通常需要多种药物，导致多重用药，即同时使用五种或更多药物。
本研究旨在估计并比较AD诊断前一年与非AD个体多重用药的患病率。采用匹配横断面设计，使用来自IADB.nl处方数据库（1994 - 2021年）的数据，包括65岁及以上且一年内至少有一张AD药物处方的个体。对照组按年龄和性别以9:1的比例匹配。分析按时间段（≤2010年和>2010年）分层，并进一步按性别和年龄分层。
纳入4150名AD个体并与37350名对照组匹配。与对照组相比，AD个体多重用药的患病率更高，≤2010年（比值比：1.15，95%置信区间：1.03 - 1.29），>2010年（比值比：1.25，95%置信区间：1.16 - 1.36）。患有AD的女性多重用药的几率略高于男性。患病率在不同时间段和年龄组中一致，65 - 74岁个体的几率最高。
荷兰的AD个体在AD诊断前一年多重用药的患病率显著更高。研究结果突出了管理AD个体多种合并症的复杂性，强调需要定期审查和优化药物治疗方案，并纳入非药物干预措施，以尽量减少不良后果并提高生活质量。
