Psychotropic medication use is higher in early‐ than late‐onset Alzheimer’s disease

Abstract

AbstractBackgroundPsychotropic medication use in Alzheimer’s disease (AD) is important in symptom management as neuropsychiatric symptoms (NPS) often reduced quality of life for both patients and families. The extent to which these medications are prescribed at similar or discrepant rates between those with early symptom onset (EOAD) and late symptom onset (LOAD) is unknown but may have important implicants for clinical careMethodData were obtained from the National Alzheimer’s Coordinating Center database. Baseline data from those with primary Alzheimer’s disease (AD) diagnosis were used for this analysis. Baseline was defined as the first time the individual was diagnosed with impaired cognition. Participants who completed the Neuropsychiatric Inventory Questionnaire (NPI‐Q) at baseline and had psychotropic medication use data available were included. Participants were excluded if they had additional neurological, systemic, psychiatric, or medical disease that could have significantly contributed to cognitive impairment. The AD group was divided into EOAD (n = 2796) or LOAD (n = 8446) using onset age < 65 or ≥65, respectively.Multiple logistic regression models (examining any medication use) and multiple poisson regression models (examining number of medications used) were run for each of the NPI‐Q categories to examine the association between age of symptom onset (i.e., EOAD, LOAD) and medication use, adjusting for sex, education and disease severity (CDR‐SB).ResultParticipant demographics are in Table 1. EOAD were more likely than LOAD participants to be taking at least one psychotropic medication for all NPS, except motor disturbance and nighttime behaviors (OR range: 1.16‐1.47; Table 2). Similarly, EOAD compared to LOAD participants were more likely to be taking a greater number of medications for each NPS, except motor disturbance (OR range: 1.10‐1.33; Table 3).ConclusionCompared to LOAD, EOAD is associated with increased psychotropic medication use at baseline – in terms of both presence and number of mediations prescribed – for almost all NPS. This fits well with previous findings showing greater NPS burden in EOAD. Future research will examine medication use longitudinally and explore potential group differences in efficacy.