Prevalence and Incidence of Statin Use and 3-Year Adherence and Discontinuation Rates Among Older Adults With Dementia

Author:

Ofori-Asenso Richard12,Ilomaki Jenni34,Tacey Mark1,Curtis Andrea J.5,Zomer Ella1,Bell J. Simon3467,Zoungas Sophia5,Liew Danny1ORCID

Affiliation:

1. Centre of cardiovascular Research and Education in therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

2. Epidemiological Modelling Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

3. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia

4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

5. Division of Metabolism, Ageing, and Genomics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

6. School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia

7. NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, New South Wales, Australia

Abstract

Objective: To examine the patterns of statin use and determine the 3-year adherence and discontinuation rates among a cohort of Australians aged ≥65 years with dementia. Methods: The yearly prevalence and incidence of statin use were compared via Poisson regression modeling using 2007 as the reference year. People with dementia were identified according to dispensing of antidementia medications. A cohort of 589 new statin users was followed longitudinally. Adherence was estimated via the proportion of days covered (PDC). Discontinuation was defined as ≥90 days without statin coverage. Results: The annual prevalence of statin use among older Australians with dementia increased from 20.6% in 2007 to 31.7% in 2016 (aged-sex adjusted rate ratio: 1.51, 95% confidence interval: 1.35-1.69). Among the new users, the proportion adherent (PDC ≥ 0.80) decreased from 60.3% at 6 months to 31.0% at 3 years. During the 3-year follow-up, 58.7% discontinued their statin. Conclusions: Despite increased use of statins among older Australians with dementia, adherence is low and discontinuation is high, which may point to intentional cessation.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health,Geriatrics and Gerontology,Clinical Psychology,General Neuroscience

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