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Drug May Delay Nursing Home Placement for Dementia Patients

Publishing in the September issue of Alzheimer’s Disease and Associated Disorders researchers from the University of South Florida’s Louis de la Parte Florida Mental Health// Institute’s (FMHI) Department of Mental Health, Law and Policy and the School of Aging Studies report finding that treating dementia patients with cholinesterase inhibitors (ChE-Is) may delay placement into nursing homes and provide improved quality of life while helping preserve personal and societal resources.

“Dementia is a very debilitating condition,” said co-author Ross Andel of the USF School of Aging Studies and the Florida Alzheimer’s Disease Research Center. “It affects up to 10 percent of adults over 65 and can account for up to 70 percent of the long-term care, nursing home population. This study provided evidence that treatment with ChE-Is can delay nursing home placement by an average of three and a half months, possibly as a function of temporary stabilization of cognitive and functional abilities.”

According to the Alzheimer’s Association (http://www.alz.org), ChE-Is are designed to increase levels of acetylcholine, a chemical messenger involved in memory and thought processing. The drug, first approved by the FDA in 1993, is known by several trade names, including Aricept, Exelon and Razadyne http://www.alz.org/Resources/
TopicIndex/cholinesteraseinhibitors.asp

To carry out this study, researchers used records from the Florida Medicaid program to follow separate groups of patients over age 60 with dementia who were either taking or not taking ChE-Is and had not been placed in a nursing home.

“The group of patients who were already taking ChE-Is were significantly older and included more women,” said lead author Marion Becker of FMHI. “That those taking ChE-Is were placed in a nursing home more than three months later than those not taking the drug has implications not only for patients and their families, but for controlling the rising costs of Medicaid.”

Cost effectiveness is also a consideration when expensive drugs are used in the Medicaid system.

“The cost of the therapy can be off-set by the financial benefits that come with nursing home placement delay,” Becker added.

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