Treatment practices of mild cognitive impairment in California Alzheimer's Disease Centers

J Am Geriatr Soc. 2009 Apr;57(4):686-90. doi: 10.1111/j.1532-5415.2009.02200.x.

Abstract

Objectives: To examine "real world" treatments for patients with mild cognitive impairment (MCI).

Design: Cross-sectional.

Setting: California Department of Public Health Alzheimer's Disease (AD) Research Centers of California.

Participants: Five hundred seventy-eight patients diagnosed with MCI.

Measurements: All patients underwent comprehensive neurological and neuropsychological evaluations. Logistic regression models were used to determine patient characteristics associated with use of anti-AD medications, statins, antioxidants, and folic acid.

Results: One hundred sixty-six patients (28.7%) were taking anti-AD medications; use was associated with greater functional impairment, higher education, MCI subtype, and older age (P<.05 for all). Two hundred fifty-two patients (43.6%) were taking statins; use was associated with diabetes mellitus, hypertension, myocardial infarct, male sex, and MCI subtype (P<.05 for all). One hundred fifteen patients (19.9%) were taking antioxidants; use was associated with higher education and diabetes mellitus and varied according to site (P<.05 for all). Thirty-seven patients (6.4%) were taking folic acid; use was associated with nonwhite race, male sex, and greater functional impairment (P<.05 for all).

Conclusion: This study suggests that patients with MCI are frequently being treated with "off label" cholinesterase inhibitors and memantine, as well as other possible cognition-enhancing drugs. Further investigation of the effect of treatment patterns on the clinical course of MCI is needed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Alzheimer Disease / drug therapy*
  • Antioxidants / therapeutic use
  • California
  • Chi-Square Distribution
  • Cholinesterase Inhibitors / therapeutic use
  • Cross-Sectional Studies
  • Dopamine Agents / therapeutic use
  • Female
  • Folic Acid / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Logistic Models
  • Male
  • Memantine / therapeutic use
  • Nootropic Agents / therapeutic use
  • Practice Patterns, Physicians' / statistics & numerical data*

Substances

  • Antioxidants
  • Cholinesterase Inhibitors
  • Dopamine Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Nootropic Agents
  • Folic Acid
  • Memantine