Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지
DOI QR코드

DOI QR Code

Analysis of Cardiovascular Medication Use in Dementia Patients

치매환자에서의 심혈관계 약물사용 분석

  • Rhew, Kiyon (College of Pharmacy, Dongduk Women's University)
  • Received : 2017.09.15
  • Accepted : 2017.09.26
  • Published : 2017.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Dementia is one of important social and economic healthcare issues in the aging age. Therefore, it signifies to analyze the relationship between chronic disease or cardiovascular drug use and the incidence of dementia to establish a basis for increasing or preventing the risk of dementia. The purpose of this study was to investigate the correlation between the prevalence of chronic diseases and the use of cardiovascular drugs in patients diagnosed with dementia. Methods: In this study, we used data from sample of elderly patients from the Health Insurance Review and Assessment Service. We analyzed by logistic regression analysis with age, gender, and medication as covariates. KCD-7 was used to diagnosis of the disease, and drugs were analyzed using ATC codes and Korean standardized drug classification codes. Results: A total of 1,276,331 patients were analyzed in the sample of the elderly population, of which 532,075 (41.7%) were male and 744,256 (58.3%) were female. The patients have the higher risk of dementia in the older, women, and lower socioeconomically status. Cerebral infarction and ischemic heart disease increases risk of dementia. Patients taking statins, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonists (ARB) showed low incidence of dementia. Conclusion: This study has been shown that ACEI, ARB, and statin drugs may associate with lower incidence of Alzheimer's and other dementia except vascular dementia.

Keywords

References

  1. Sacuiu SF. Dementias. Handb Clin Neurol. 2016;138:123-51.
  2. Kelley AS, McGarry K, Gorges R, et al. The burden of health care costs for patients with dementia in the last 5 years of life. Ann Intern Med. 2015;163:729-36. https://doi.org/10.7326/M15-0381
  3. Mougias AA, Politis A, Mougias MA, et al. The burden of caring for patients with dementia and its predictors. Psychiatriki. 2015;26:28-37.
  4. Joling KJ, Bosmans JE, van Marwijk HW, et al. The cost-effectiveness of a family meetings intervention to prevent depression and anxiety in family caregivers of patients with dementia: a randomized trial. Trials. 2013;14:305 https://doi.org/10.1186/1745-6215-14-305
  5. Hurd MD, Martorell P, Delavande A, et al. Monetary costs of dementia in the United States. N Engl J Med. 2013;368:1326-34. https://doi.org/10.1056/NEJMsa1204629
  6. Corrada MM, Brookmeyer R, Berlau D, et al. Prevalence of dementia after age 90: results from the 90+ study. Neurology 2008;71:337-43. https://doi.org/10.1212/01.wnl.0000310773.65918.cd
  7. Hall CB, Verghese J, Sliwinski M, et al. Dementia incidence may increase more slowly after age 90: results from the Bronx Aging Study. Neurology 2005;65:882-6. https://doi.org/10.1212/01.wnl.0000176053.98907.3f
  8. Corrada MM, Brookmeyer R, Paganini-Hill A, et al. Dementia incidence continues to increase with age in the oldest old: the 90+ study. Ann Neurol 2010; 67:114-21. https://doi.org/10.1002/ana.21915
  9. Gregg EW, Yaffe K, Cauley JA, et al. Is diabetes associated with cognitive impairment and cognitive decline among older women? Study of Osteoporotic Fractures Research Group. Arch Intern Med 2000;160:174-80. https://doi.org/10.1001/archinte.160.2.174
  10. Rawlings AM, Sharrett AR, Schneider AL, et al. Diabetes in midlife and cognitive change over 20 years: a cohort study. Ann Intern Med 2014; 161:785-93. https://doi.org/10.7326/M14-0737
  11. Katon W, Pedersen HS, Ribe AR, et al. Effect of depression and diabetes mellitus on the risk for dementia: a national population-based cohort study. JAMA Psychiatry 2015;72:612-9. https://doi.org/10.1001/jamapsychiatry.2015.0082
  12. Ng TP, Feng L, Nyunt MS, et al. Metabolic Syndrome and the Risk of Mild Cognitive Impairment and Progression to Dementia: Follow-up of the Singapore Longitudinal Ageing Study Cohort. JAMA Neurol 2016; 73:456-63. https://doi.org/10.1001/jamaneurol.2015.4899
  13. Li W, Risacher SL, Huang E, et al. Type 2 diabetes mellitus is associated with brain atrophy and hypometabolism in the ADNI cohort. Neurology 2016; 87:595-600.
  14. Alonso A, Mosley TH Jr, Gottesman RF, et al. Risk of dementia hospitalisation associated with cardiovascular risk factors in midlife and older age: the Atherosclerosis Risk in Communities (ARIC) study. J Neurol Neurosurg Psychiatry 2009; 80:1194-201. https://doi.org/10.1136/jnnp.2009.176818
  15. Freitag MH, Peila R, Masaki K, et al. Midlife pulse pressure and incidence of dementia: the Honolulu-Asia Aging Study. Stroke 2006;37:33-7. https://doi.org/10.1161/01.STR.0000196941.58869.2d
  16. Obisesan TO, Obisesan OA, Martins S, et al. High blood pressure, hypertension, and high pulse pressure are associated with poorer cognitive function in persons aged 60 and older: the Third National Health and Nutrition Examination Survey. J Am Geriatr Soc 2008; 56:501-9. https://doi.org/10.1111/j.1532-5415.2007.01592.x
  17. Tsivgoulis G, Alexandrov AV, Wadley VG, et al. Association of higher diastolic blood pressure levels with cognitive impairment. Neurology 2009; 73:589-95 https://doi.org/10.1212/WNL.0b013e3181b38969
  18. Haring B, Leng X, Robinson J, et al. Cardiovascular disease and cognitive decline in postmenopausal women: results from the Women's Health Initiative Memory Study. J Am Heart Assoc 2013;2:e000369. https://doi.org/10.1161/JAHA.113.000369
  19. Dublin S, Anderson ML, Haneuse SJ, et al. Atrial fibrillation and risk of dementia: a prospective cohort study. J Am Geriatr Soc 2011;59:1369-75. https://doi.org/10.1111/j.1532-5415.2011.03508.x
  20. de Bruijn RF, Heeringa J, Wolters FJ, et al. Association Between Atrial Fibrillation and Dementia in the General Population. JAMA Neurol 2015; 72:1288-94. https://doi.org/10.1001/jamaneurol.2015.2161
  21. Larson EB, Wang L, Bowen JD, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Intern Med 2006;144:73-81. https://doi.org/10.7326/0003-4819-144-2-200601170-00004
  22. Xiong GL, Plassman BL, Helms MJ, Steffens DC. Vascular risk factors and cognitive decline among elderly male twins. Neurology 2006;67:1586-91. https://doi.org/10.1212/01.wnl.0000242730.44003.1d
  23. Hebert LE, Scherr PA, Bennett DA, et al. Blood pressure and late-life cognitive function change: a biracial longitudinal population study. Neurology 2004;62:2021-4. https://doi.org/10.1212/01.WNL.0000129258.93137.4B
  24. Launer LJ, Miller ME, Williamson JD, et al. Effects of intensive glucose lowering on brain structure and function in people with type 2 diabetes (ACCORD MIND): a randomised open-label substudy. Lancet Neurol 2011; 10:969-77. https://doi.org/10.1016/S1474-4422(11)70188-0
  25. Deary IJ, Whalley LJ, Batty GD, et al. Physical fitness and lifetime cognitive change. Neurology 2006; 67:1195-200. https://doi.org/10.1212/01.wnl.0000238520.06958.6a
  26. Wilson RS, Scherr PA, Schneider JA, et al. Relation of cognitive activity to risk of developing Alzheimer disease. Neurology 2007;69:1911-20. https://doi.org/10.1212/01.wnl.0000271087.67782.cb
  27. Hendrie HC, Hake A, Lane K, et al. Statin Use, Incident Dementia and Alzheimer Disease in Elderly African Americans. Ethn Dis 2015;25:345-54. https://doi.org/10.18865/ed.25.3.345
  28. Chen PY, Liu SK, Chen CL, et al. Long-term statin use and dementia risk in Taiwan. Geriatr Psychiatry Neurol. 2014;27(3):165-71. https://doi.org/10.1177/0891988714522702
  29. Kuan YC, Huang KW, Yen DJ, et al. Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers reduced dementia risk in patients with diabetes mellitus and hypertension. Int J Cardiol. 2016;220:462-6. https://doi.org/10.1016/j.ijcard.2016.06.215
  30. WHO ATC code search, June 2017. Available from https://www.whocc.no/atc_ddd_index/.Accessed August 8, 2017.
  31. Rullier L, Lagarde A, Bouisson J, et al. Nutritional status of community-dwelling older people with dementia: associations with individual and family caregivers' characteristics. Int J Geriatr Psychiatry. 2013;28:580-8. https://doi.org/10.1002/gps.3862
  32. Stern Y, Gurland B, Tatemichi TK, et al. Influence of education and occupation on the incidence of Alzheimer's disease. JAMA 1994;271:1004-10. https://doi.org/10.1001/jama.1994.03510370056032
  33. Evans DA, Hebert LE, Beckett LA, et al. Education and other measures of socioeconomic status and risk of incident Alzheimer disease in a defined population of older persons. Arch Neurol 1997;54:1399-405. https://doi.org/10.1001/archneur.1997.00550230066019
  34. Prince M, Acosta D, Ferri CP, et al. Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study. Lancet 2012;380:50-8. https://doi.org/10.1016/S0140-6736(12)60399-7
  35. Beydoun MA, Beason-Held LL, Kitner-Triolo MH, et al. Statins and serum cholesterol's associations with incident dementia and mild cognitive impairment. J Epidemiol Community Health 2011;65:949-57. https://doi.org/10.1136/jech.2009.100826
  36. Parker BA, Polk DM, Rabdya V, et al. Changes in memory function and neuronal activation associated with atorvastatin therapy. Pharmacotherapy 2010;30:236e-40e. https://doi.org/10.1592/phco.30.3.236
  37. Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2889-934. https://doi.org/10.1016/j.jacc.2013.11.002
  38. Swiger KJ1, Manalac RJ, Blumenthal RS,.Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects. Mayo Clin Proc 2013;88:1213-21. https://doi.org/10.1016/j.mayocp.2013.07.013
  39. Richardson K, Schoen M, French B, Umscheid CA, Mitchell MD, Arnold SE, et al. Statins and cognitive function: a systematic review. Ann Intern Med 2013;159:688-97. https://doi.org/10.7326/0003-4819-159-10-201311190-00007