| アブストラクト | INTRODUCTION: Diagnostic subtype has been suggested as a determinant of inequity for people with dementia; its impact on primary care provision is underexplored. This study investigated the association between dementia subtype and likelihood of receiving guideline-consistent primary care. METHOD: Retrospective cohort study using Clinical Practice Research Datalink (Aurum) database, 1.1.2006-30.06.2024. We examined potential inequity with eight dementia subtypes: Alzheimer's disease (AD), Lewy body dementia (LBD), vascular, frontotemporal, unspecified, other and two mixed categories. Six outcomes were examined: care plan or medication review (both within 24 months of index) and four indicators of potentially inappropriate prescribing (PIP) (high anti-cholinergic burden drugs, z-drugs, benzodiazepines and anti-psychotics). Cox-regression models were used, adjusting for: age, sex, comorbidities, deprivation and ethnicity. RESULTS: A total of 571 663 people were included and 72.1% received a care plan; 79.4% received a medication review within 24 months. Compared to AD: people with mixed dementias were more likely to receive a care plan [hazard ratio (HR) 1.29, 95% confidence interval (CI) 1.26-1.32 for mixed including AD/LBD, HR 1.37, 1.32-1.43 for mixed non-AD/LBD]. All other subtypes were less likely to receive a care plan. Individuals with mixed AD/LBD (HR 1.28, 1.26-1.32), mixed non-AD/LBD (HR 1.35, 1.26-1.45), vascular (HR 1.05, CI 1.04-1.07), LBD (HR 1.02, 1.01-1.04) and unspecified (HR 1.02, 1.01-1.03) were more likely to receive medication reviews. Compared to AD, all other subtypes were more likely to experience PIP across all four indicators. CONCLUSION: We found greater likelihood of PIP in people with non-AD dementias, a novel finding. Further research is needed, especially with new AD drugs potentially widening disparities. |
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| ジャーナル名 | Age and ageing |
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| Pubmed追加日 | 2026/4/20 |
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| 投稿者 | Morris, Charlotte; Mok, Pearl L H; Robinson, Dame Louise; Ashcroft, Darren M; Blakeman, Tom; Kontopantelis, Evangelos |
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| 組織名 | Division of Population Health, Health Services Research and Primary Care School;of Health Sciences, The University of Manchester, Manchester, M13 9PL, UK.;NIHR Greater Manchester Patient Safety Research Collaboration, The University of;Manchester, Manchester, M13 9PL, UK.;NIHR School for Primary Care Research, The University of Manchester, Manchester,;M13 9PL, UK.;Division of Pharmacy and Optometry, School of Health Sciences, The University of;Manchester, Manchester, England, M13 9PL, UK.;Population Health Science Institute, Faculty of Medical Science, University of;Newcastle upon Tyne, Newcastle upon Tyne, NE1 7RU, UK.;England, M13 9PL, UK.;Division of informatics, Imaging and Data Sciences, The University of Manchester,;Manchester, UK.;Division of Family Medicine, Yong Loo Lin School of Medicine, National University;of Singapore, Singapore 119228, Singapore. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42003348/ |
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