OBJECTIVES: Investigate the trends in Anti-alzheimer's medication utilization and associated patient characteristics and generate annualized estimates at country-level, in Spain. METHODS: AlzheimerMonitor is a multi-year annual study conducted among neurologists/ psychiatrists/geriatricians to collect chart data on patients with AD diagnosis and/or documented anti-alzheimer's medication use. 2005 & 2006 data on patient demographics, disease severity and medication utilization were used for this analysis to assess trends. A multi-stage weighting method at physician/patient level was employed to extrapolate data to Spain population. RESULTS: Over 3100 patient charts were abstracted each year by over 170 specialists from diverse settings in 2005 & 2006; 71,184 & 80,510 patients were estimated to have AD and/or have used anti-alzheimer's medications in Spain in 2005 & 2006; 50,470 (71%) & 62,658 (78%) had confirmed AD diagnosis in 2005 & 2006, while the rest had diagnosis of other dementias. Overall medication utilization included (not mutually exclusive): AD-medications (2005:90%, 2006:88%), antipsychotics (2005:10%, 2006:12%), antidepressants (2005:7%, 2006:8%), anxiolytics (2005/2006: 5%), hypnotics/sedatives (2005/2006: 3%), psychostimulants/neroptropics (2005:4%, 2006:1%). AD-medication utilization trends (not mutually exclusive) among all patients included (2005/2006, % patients): donepezil (40%/38%), memantine (22%/27%), rivastigmine (24%/25%) and galantamine (21%/22%). Among patients with AD diagnosis, average age was 76yrs (2005/2006); AD severity distribution (2005/2006, % patients) was – mild: 17.7%/21.3%, moderate: 44.2%/45.1%, moderately-severe: 23.1%/24.5%, severe: 14.4%/8.6%. 86% (2005) & 88% (2006) of AD-patients were treated with anti-alzheimer's medications; utilization in this group included: donepezil (2005:40%, 2006:38%), memantine (2005:22%, 2006:27%), rivastigmine (2005:24%, 2006:25%) and galantamine (2005:21%, 2006:22%). CONCLUSION: More than two-third of anti-alzheimer's medication users had AD diagnosis and this group size increased from 2005 to 2006, primarily in the mild/moderate disease categories. In contrary, at least one-in-ten AD patients were not on anti-alzheimer's medication both in 2005 and 2006. Closer scrutiny on these trends is required to alleviate AD disease burden.