Alzheimer's disease medication and risk of all-cause mortality and all-cause hospitalization: A retrospective cohort study

Sandipan Bhattacharjee, Asad E Patanwala, Wei Hsuan Lo-Ciganic, Daniel C. Malone, Jeannie K Lee, Shannon M. Knapp, Terri L Warholak, William J. Burke

Research output: Contribution to journalArticle

Abstract

Introduction: Identifying Alzheimer's disease (AD) pharmacologic treatment options that effectively reduce the risk of mortality and hospitalization in real-world settings is critical. Methods: We compared donepezil, galantamine, memantine, oral rivastigmine, and transdermal rivastigmine with regard to all-cause mortality and all-cause hospitalization risk among fee-for-service Medicare beneficiaries with AD (aged ≥ 65 years) using a retrospective cohort study design. Our primary analysis was based on intention to treat (ITT), but we also present as-treated analysis. Results: In our final study sample (N = 21,558), significant difference in survival among index AD medication groups were observed with donepezil being associated with better survival than memantine, and oral and transdermal forms of rivastigmine for both ITT and as-treated analysis. Difference in hazards of all-cause hospitalization among index AD medication groups was observed in ITT analysis but not in as-treated analysis. Discussion: Significant differences exist in terms of mortality and hospitalization risk with different AD medication initiation in real-world setting.

Original languageEnglish (US)
Pages (from-to)294-302
Number of pages9
JournalAlzheimer's and Dementia: Translational Research and Clinical Interventions
Volume5
DOIs
StatePublished - Jan 1 2019

Fingerprint

Rivastigmine
Alzheimer Disease
Hospitalization
Cohort Studies
Retrospective Studies
Mortality
Memantine
Galantamine
Fee-for-Service Plans
Intention to Treat Analysis
Medicare

Keywords

  • All-cause hospitalization
  • All-cause mortality
  • Alzheimer's disease medications
  • Inverse probability of treatment weighting
  • Safety
  • Survival analysis

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

@article{c48acdc7648043e1a686e921ef7e590f,
title = "Alzheimer's disease medication and risk of all-cause mortality and all-cause hospitalization: A retrospective cohort study",
abstract = "Introduction: Identifying Alzheimer's disease (AD) pharmacologic treatment options that effectively reduce the risk of mortality and hospitalization in real-world settings is critical. Methods: We compared donepezil, galantamine, memantine, oral rivastigmine, and transdermal rivastigmine with regard to all-cause mortality and all-cause hospitalization risk among fee-for-service Medicare beneficiaries with AD (aged ≥ 65 years) using a retrospective cohort study design. Our primary analysis was based on intention to treat (ITT), but we also present as-treated analysis. Results: In our final study sample (N = 21,558), significant difference in survival among index AD medication groups were observed with donepezil being associated with better survival than memantine, and oral and transdermal forms of rivastigmine for both ITT and as-treated analysis. Difference in hazards of all-cause hospitalization among index AD medication groups was observed in ITT analysis but not in as-treated analysis. Discussion: Significant differences exist in terms of mortality and hospitalization risk with different AD medication initiation in real-world setting.",
keywords = "All-cause hospitalization, All-cause mortality, Alzheimer's disease medications, Inverse probability of treatment weighting, Safety, Survival analysis",
author = "Sandipan Bhattacharjee and Patanwala, {Asad E} and Lo-Ciganic, {Wei Hsuan} and Malone, {Daniel C.} and Lee, {Jeannie K} and Knapp, {Shannon M.} and Warholak, {Terri L} and Burke, {William J.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.trci.2019.05.005",
language = "English (US)",
volume = "5",
pages = "294--302",
journal = "Alzheimer's and Dementia: Translational Research and Clinical Interventions",
issn = "2352-8737",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Alzheimer's disease medication and risk of all-cause mortality and all-cause hospitalization

T2 - A retrospective cohort study

AU - Bhattacharjee, Sandipan

AU - Patanwala, Asad E

AU - Lo-Ciganic, Wei Hsuan

AU - Malone, Daniel C.

AU - Lee, Jeannie K

AU - Knapp, Shannon M.

AU - Warholak, Terri L

AU - Burke, William J.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Identifying Alzheimer's disease (AD) pharmacologic treatment options that effectively reduce the risk of mortality and hospitalization in real-world settings is critical. Methods: We compared donepezil, galantamine, memantine, oral rivastigmine, and transdermal rivastigmine with regard to all-cause mortality and all-cause hospitalization risk among fee-for-service Medicare beneficiaries with AD (aged ≥ 65 years) using a retrospective cohort study design. Our primary analysis was based on intention to treat (ITT), but we also present as-treated analysis. Results: In our final study sample (N = 21,558), significant difference in survival among index AD medication groups were observed with donepezil being associated with better survival than memantine, and oral and transdermal forms of rivastigmine for both ITT and as-treated analysis. Difference in hazards of all-cause hospitalization among index AD medication groups was observed in ITT analysis but not in as-treated analysis. Discussion: Significant differences exist in terms of mortality and hospitalization risk with different AD medication initiation in real-world setting.

AB - Introduction: Identifying Alzheimer's disease (AD) pharmacologic treatment options that effectively reduce the risk of mortality and hospitalization in real-world settings is critical. Methods: We compared donepezil, galantamine, memantine, oral rivastigmine, and transdermal rivastigmine with regard to all-cause mortality and all-cause hospitalization risk among fee-for-service Medicare beneficiaries with AD (aged ≥ 65 years) using a retrospective cohort study design. Our primary analysis was based on intention to treat (ITT), but we also present as-treated analysis. Results: In our final study sample (N = 21,558), significant difference in survival among index AD medication groups were observed with donepezil being associated with better survival than memantine, and oral and transdermal forms of rivastigmine for both ITT and as-treated analysis. Difference in hazards of all-cause hospitalization among index AD medication groups was observed in ITT analysis but not in as-treated analysis. Discussion: Significant differences exist in terms of mortality and hospitalization risk with different AD medication initiation in real-world setting.

KW - All-cause hospitalization

KW - All-cause mortality

KW - Alzheimer's disease medications

KW - Inverse probability of treatment weighting

KW - Safety

KW - Survival analysis

UR - http://www.scopus.com/inward/record.url?scp=85068571466&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068571466&partnerID=8YFLogxK

U2 - 10.1016/j.trci.2019.05.005

DO - 10.1016/j.trci.2019.05.005

M3 - Article

AN - SCOPUS:85068571466

VL - 5

SP - 294

EP - 302

JO - Alzheimer's and Dementia: Translational Research and Clinical Interventions

JF - Alzheimer's and Dementia: Translational Research and Clinical Interventions

SN - 2352-8737

ER -