Comorbidity profile of dementia patients in primary care: are they sicker?

نویسندگان

  • Cathy C Schubert
  • Malaz Boustani
  • Christopher M Callahan
  • Anthony J Perkins
  • Caroline P Carney
  • Christopher Fox
  • Frederick Unverzagt
  • Siu Hui
  • Hugh C Hendrie
چکیده

OBJECTIVES To compare the medical comorbidity of older patients with and without dementia in primary care. DESIGN Cross-sectional study. SETTING Wishard Health Services, which includes a university-affiliated, urban public hospital and seven community-based primary care practice centers in Indianapolis. PARTICIPANTS Three thousand thirteen patients aged 65 and older attending seven primary care centers in Indianapolis, Indiana. MEASUREMENTS An expert panel diagnosed dementia using International Classification of Diseases, 10th Revision, criteria. Comorbidity was assessed using 10 physician-diagnosed chronic comorbid conditions and the Chronic Disease Score (CDS). RESULTS Patients with dementia attending primary care have on average 2.4 chronic conditions and receive 5.1 medications. Approximately 50% of dementia patients in this setting are exposed to at least one anticholinergic medication, and 20% are prescribed at least one psychotropic medication. After adjusting for patients' age, race, and sex, patients with and without dementia have a similar level of comorbidity (mean number of chronic medical conditions, 2.4 vs 2.3, P=.66; average CDS, 5.8 vs 6.2, P=.83). CONCLUSION Multiple medical comorbid conditions are common in older adults with and without dementia in primary care. Despite their cholinergic deficit, a substantial proportion of patients with dementia are exposed to anticholinergic medications. Models of care that incorporate this medical complexity are needed to improve the treatment of dementia in primary care.

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عنوان ژورنال:
  • Journal of the American Geriatrics Society

دوره 54 1  شماره 

صفحات  -

تاریخ انتشار 2006