OBJECTIVES: Dementia in the elderly has become a major public health concern. Currently, cholinesterase inhibitors and memantine are approved for treatment of patients with dementia. The current study aim was to examine the clinical and medication use characteristics of elderly patients with dementia in the United States.

METHODS: This retrospective cohort study used 2013 Medicare Claims Data involving parts A, B, and D. The study included patients aged ≥65 years with a diagnosis of dementia before 30 June 2013 and who were continuously enrolled in Parts A, B, and D. This study used the Master Beneficiary Summary Base file, Master Beneficiary Summary Chronic Conditions file, outpatient claims file, MEDPAR file, and Medicare Part D Event/Drug characteristics file. Use of cholinesterase inhibitors (ChEIs) (donepezil, galantamine, and rivastigmine) and N-Methyl-D-Aspartate antagonist (memantine) were identified using National Drug Codes. Descriptive statistics was used to describe the demographic and clinical characteristics including use of ChEIs by the elderly dementia patients.

RESULTS: Between 1 January 2013 – 30 June 2013, there were 1.86 million eligible elderly Medicare beneficiaries with dementia. Most of the dementia patients were female (69.71%), belonged to the age group 85-94 years (38.95%), and were White (81.19%). The most common comorbid conditions were hypertension (74.14%), hyperlipidemia (48.26%), and depression (35.97%). Anti-dementia medications were prescribed in 63.62% of the patients and ChEIs were the most frequently prescribed (40.07%). The majority of patients were prescribed donepezil (32.38%), followed by memantine (23.55%), rivastigmine (7.95%), and galantamine (1.48%).

CONCLUSIONS: Over 6 out of 10 elderly dementia patients were prescribed anti-dementia medications to manage their condition, and nearly 40% of the patients received ChEIs, mainly donepezil. Given the increasing burden of dementia among the elderly, more research is needed to study the real-world medication utilization pattern and outcomes in this vulnerable study population.