Lower Barthel Index Scores Predict Less Prescription of Pharmacological Therapy in Elderly Patients with Alzheimer Disease

Abstract

Aims: To determine the factors associated with receiving specific treatment (cholinesterase inhibitors or/and memantine) for Alzheimer disease (AD) in elderly patients. Methods: An observational study carried out in 289 consecutive outpatients aged >64 years with dementia. We collected data on specific AD therapy, sociodemographic variables, Barthel Index (BI), Lawton and Brody Index (LI), Mini Mental State Examination, Global Deterioration Scale (GDS), Charlson Index and the total number of drugs chronically prescribed. Patients receiving specific therapy for dementia were compared with the rest. Results: Two hundred and thirty-three (80.6%) patients were receiving specific treatment for dementia, with 197 (84.5%) receiving monotherapy and the rest (15.4%) combined therapy. The bivariate analysis showed that age, marital status, place of residence, BI and LI, cognitive status and disease severity (GDS) were factors associated with receiving specific dementia therapy. Multiple stepwise logistic regression analysis showed that a lower BI (β = –0.25; odds ratio 0.976, 95% confidence interval = 0.966–0.986; p < 0.0001) was the only factor independently associated with not receiving specific therapy for AD. Conclusions: Of the possible factors related to elderly patients receiving specific therapy for AD, a poor BI score was the most important factor associated with not receiving treatment.

Prescribing patterns in dementia: a multicentre observational study in a German network of CAM physicians

“…cholinesterase inhibitors, memantine and/or Ginkgo biloba ). While odds ratios for Alzheimer's disease are presumably higher than those for vascular dementia, it is in accordance with the results of Formiga and Frisoni [36,40]. Moreover, there are several hints of different prescribing patterns of neurologists and GPs [25,38].…”

“…According to Formiga, lower Barthel Index scores predict fewer prescriptions of pharmcological therapy in Alzheimer's disease [40]. Other factors like patient age, gender, co-morbidity, neuroleptic and antidepressant therapy, and hospital admission in the previous year show no significance after adjusting the multivariate logistic regression model.…”

Effectiveness of collaborative treatment using Korean and Western medicine for mild cognitive impairment or dementia

“…It is scored on a scale of 1 to 7 (0, no cognitive decline; 2, very mild cognitive decline; 3, mild cognitive decline; 4, moderate cognitive decline; 5, moderately severe cognitive decline; 6, severe cognitive decline; and 7, very severe cognitive decline). [37–39] The validity of the Korean version of the GDS has been demonstrated. [23]…”

Alterations in blink and masseter reflex latencies in older adults with neurocognitive disorder and/or diabetes mellitus

“…Dependence has also been related to ND: Formiga et al [ 44 ] found that only 15.3% of patients with AD were independent, in addition to an association between severe dementia and low scores on the Barthel Index. Aside from the cultural role of older adults with ND, and the lack of social occupation, general motor system dysfunction has been shown in AD, which could be relevant to the appearance of contractures, followed by immobility, and decreased muscular tone[ 45 ].…”