Semla T P, Cohen D, Paveza G, Eisdorfer C, Gorelick P, Luchins D, Hirschman R, Freels S, Levy P, Ashford J W
Department of Pharmacy Practice, College of Pharmacy, University of Illinois, Chicago 60612.
J Am Geriatr Soc. 1993 Apr;41(4):408-13. doi: 10.1111/j.1532-5415.1993.tb06949.x.
To describe drug use patterns by persons with Alzheimer's disease, multi-infarct dementia, and mixed Alzheimer's disease and multi-infarct dementia.
Multicenter, patient registry.
Community-living persons evaluated in primary care, geriatric, and Alzheimer ambulatory settings.
Of the 930 persons in three diagnostic categories, there were 671 with probable or possible Alzheimer's disease by NINCDS/ADRDA criteria or Alzheimer's disease by DSM-III-R criteria, 162 multi-infarct cases by DSM-III-R criteria, and 97 mixed cases by DSM-III-R criteria. In each diagnostic category, 65% were women, and the majority were 70 years or older.
The average number of all prescription and non-prescription drugs and selected therapeutic categories by age, sex, diagnosis, and mini-mental status score at the time of diagnosis or evaluation.
Alzheimer patients average 2.3 drugs compared with multi-infarct (4.3; P < 0.0001) and mixed (3.7; P = 0.002) patients, and their pattern of drug use was different when stratified by therapeutic categories and drug classes. Drug use increased with age, and women used significantly more drugs than men in all three diagnostic categories. Women with Alzheimer's disease used significantly more cardiovascular drugs than men with Alzheimer's disease (P < 0.05). The lower the mini-mental status score in patients with any dementia, the greater the mean number of central nervous system agents used. The higher the mini-mental status score in a patient with multi-infarct or mixed dementia, the greater the use of cardiovascular drugs.
Drug use by Alzheimer patients was lower than in multi-infarct and mixed patients, primarily due to a lower prevalence of cardiovascular drugs.
描述阿尔茨海默病、多发梗死性痴呆以及阿尔茨海默病与多发梗死性痴呆混合型患者的用药模式。
多中心患者登记研究。
在初级保健、老年病科和阿尔茨海默病门诊环境中接受评估的社区居住者。
在三个诊断类别中的930人里，根据美国国立神经病学、语言障碍和卒中研究所/阿尔茨海默病及相关疾病协会（NINCDS/ADRDA）标准确诊为可能或疑似阿尔茨海默病或根据精神疾病诊断与统计手册第三版修订版（DSM-III-R）标准确诊为阿尔茨海默病的有671人，根据DSM-III-R标准确诊为多发梗死性痴呆的有162人，根据DSM-III-R标准确诊为混合型痴呆的有97人。在每个诊断类别中，65%为女性，且大多数年龄在70岁及以上。
在诊断或评估时，按年龄、性别、诊断以及简易精神状态评分统计所有处方和非处方药的平均数量以及选定的治疗类别。
阿尔茨海默病患者平均使用2.3种药物，而多发梗死性痴呆患者（4.3种；P<0.0001）和混合型痴呆患者（3.7种；P = 0.002）使用药物更多，并且当按治疗类别和药物种类分层时，他们的用药模式有所不同。用药量随年龄增加，在所有三个诊断类别中女性使用的药物明显多于男性。患有阿尔茨海默病的女性使用的心血管药物明显多于患有阿尔茨海默病的男性（P<0.05）。任何痴呆患者的简易精神状态评分越低，使用的中枢神经系统药物平均数量就越多。多发梗死性或混合型痴呆患者的简易精神状态评分越高，心血管药物的使用量就越大。
阿尔茨海默病患者的用药量低于多发梗死性痴呆和混合型痴呆患者，主要原因是心血管药物的使用率较低。
