Use of Lipid-Lowering Drugs in Older Adults With and Without Dementia: A Community-Based Epidemiological Study

Authors

  • Eric G. Rodriguez MD,

    1. Division of Geriatric Medicine, Department of Medicine, and
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  • Hiroko H. Dodge PhD,

    1. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania; and
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  • Maria A. Birzescu MS,

    1. Division of Geriatrics and Neuropsychiatry, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;
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  • Gary P. Stoehr PharmD,

    1. Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania.
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  • Mary Ganguli MD, MPH

    1. Division of Geriatrics and Neuropsychiatry, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;
    2. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania; and
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  • Presented in part as a poster at the Annual Meeting of the American Geriatrics Society, Nashville, TN, May 2000.

Address correspondence to Eric G. Rodriguez, MD, University of Pittsburgh School of Medicine, Division of Geriatric Medicine, Department of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213. E-mail: rodriguezeg@msx.upmc.edu

Abstract

OBJECTIVES: To compare the use of lipid-lowering drugs in community-dwelling older adults with and without dementia.

DESIGN: Comparison of lipid-lowering drug use by demented cases and nondemented controls based on secondary analysis of data from a longitudinal epidemiologic study.

SETTING: Longitudinal study of a largely rural, low- socioeconomic-status, community-based cohort of older persons residing in the mid-Monongahela Valley of South-west Pennsylvania (the Monongahela Valley Independent Elders Survey).

PARTICIPANTS: Eight hundred forty-five individuals of mean ± standard deviation (SD) age of 80.5 ± 4.6, participating in the fifth biennial wave of data collection.

MEASUREMENTS: Demographics; medical history; medication regimen (including examination of prescription bottle labels); self-report of most recent visit to primary care physician (PCP); and standardized clinical assessment to determine presence of dementia, including Clinical Dementia Rating (CDR).

RESULTS: One hundred seventy participants (20.1% of total subject cohort) had dementia, with a CDR of 0.5 or greater. Mean ages of demented and nondemented individuals were 83.5 ± 5.1 and 79.8 ± 4.2, respectively. Similar proportions, 87.7% and 89.5%, of these groups reported PCP visits in the previous year. Of the total sample, 9.4% (3.5% of the demented and 10.8% of the nondemented) were taking lipid-lowering drugs. After adjustment for age, sex, education, visit with PCP within the past year, and potential confounding clinical and lifestyle variables (self-reported heart disease, stroke or transient ischemic attacks, hypertension, smoking, and alcohol consumption), dementia was associated with a lower likelihood of taking a lipid-lowering drug (odds ratio = 0.39, 95% confidence interval = 0.16–0.95). In post hoc subgroup analyses, similar results were found when restricting lipid-lowering drugs to statins alone but were not statistically significant. Drug use was not associated with severity of dementia (CDR = 0.5 vs CDR ≥ 1).

CONCLUSIONS: Demented individuals were less likely than their nondemented counterparts to be taking lipid-lowering drugs. This finding could reflect different prescribing patterns by physicians for demented and nondemented patients or a possible protective effect of these drugs against dementia.

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