Trends in the Prescription and Long-Term Utilization of Antidementia Drugs Among Patients with Alzheimer’s Disease in Spain: A Cohort Study Using the Registry of Dementias of Girona
Abstract
Background Acetylcholinesterase inhibitors (AChEIs) and the N-methyl D-aspartate-antagonist memantine are indicated for the symptomatic treatment of Alzheimer's disease (AD).Objectives Our aims were to describe the baseline characteristics of patients with AD according to prescription of these treatments after the diagnostic work-up to describe long-term trends in the use of these medications and to identify baseline characteristics associated with the frequency of use of each treatment.Methods This was a cohort study with a sample of 2992 patients with AD recorded in the Registry of Dementias of Girona (ReDeGi) between 2007 and 2014. Consumption of AChEIs and memantine was assessed using the Pharmacy Unit database from the Public Catalan Healthcare Service. We used generalized estimating equation analyses to identify the baseline characteristics associated with the consumption of AChEIs and memantine over time.Results Most of the patients (70.4%; 95% confidence interval [CI] 68.7-72.0) were prescribed antidementia medication at the time of diagnosis. Of these, 75.0% (95% CI 73.1-76.8) were prescribed AChEIs, 14.7% (95% CI 13.2-16.3) were prescribed an AChEI plus memantine, and 10.3% (95% CI 9.0-11.6) were prescribed memantine. Advanced age reduced the likelihood of AChEI consumption. Mild dementia severity increased the use of AChEIs, and moderate-advanced dementia increased the likelihood of memantine consumption. After diagnosis, the likelihood of AChEI consumption decreased from the first year until the fifth, whereas the likelihood of memantine consumption, either alone or in combination with AChEIs, increased.Conclusions Antidementia drug use in this study showed the initial use of AChEIs alone with later use of AChEIs in combination with memantine and memantine alone in older patients with severe AD. Our findings are in agreement with current clinical practice guidelines for the pharmacological treatment of AD.
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In intermediate or advanced dementia, the duration and durability of monotherapy or combinatorial treatment with greater doses is linked to better overall functioning and therapeutic outcomes.
“In intermediate or advanced dementia, the duration and durability of monotherapy or combinatorial treatment modality with greater doses is linked to better overall functioning and therapeutic outcomes (Calvó-Perxas et al., 2017).”
From An update on the novel and approved drugs for Alzheimer disease (2022) · cites this paper as Calvó-Perxas et al., 2017
Duration and persistence of monotherapy or combination treatment with higher doses in moderate or advanced dementia are associated with better global function and outcomes.
“Duration and persistence of monotherapy or combination treatment with higher doses in moderate or even in advanced dementia are associated with better global function and outcomes.20”
From Current and Future Treatments in Alzheimer Disease: An Update (2020) · cites this paper as [20]
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
The Clinical Dementia Rating (CDR): Current version and scoring rules
Morris, J. C. (1993) · Neurology · doi:10.1212/wnl.43.11.2412-a · Cited by 9,882 · see citing works
Blessed, G., Tomlinson, B. E., & Roth, M. (1968) · British Journal of Psychiatry · doi:10.1192/bjp.114.512.797 · Cited by 4,117 · see citing works
Cholinesterase inhibitors for Alzheimer's disease
Birks, J. S. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005593 · Cited by 1,906 · see citing works
McShane, R., Areosa Sastre, A., & Minakaran, N. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003154.pub5 · Cited by 1,155 · see citing works
Holtz, T. H., Kachur, S. P., MacArthur, J. R., Roberts, J. M., Barber, A. M., Steketee, R. W., & Parise, M. E. (2001) · PsycEXTRA Dataset · doi:10.1037/e548252006-001 · Cited by 1,018 · see citing works
Raina, P., Santaguida, P., Ismaila, A., Patterson, C., Cowan, D., Levine, M., Booker, L., & Oremus, M. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-148-5-200803040-00009 · Cited by 771 · see citing works
Kavirajan, H., & Schneider, L. S. (2007) · The Lancet Neurology · doi:10.1016/s1474-4422(07)70195-3 · Cited by 497 · see citing works
Parsons, C. G., Danysz, W., Dekundy, A., & Pulte, I. (2013) · Neurotoxicity Research · doi:10.1007/s12640-013-9398-z · Cited by 337 · see citing works
Combination Therapy in Alzheimer???s Disease: A Review of Current Evidence
Schmitt, B., Bernhardt, T., Moeller, H.-J., Heuser, I., & Fr??lich, L. (2004) · CNS Drugs · doi:10.2165/00023210-200418130-00001 · Cited by 182 · see citing works
Rountree, S. D., Chan, W., Pavlik, V. N., Darby, E. J., Siddiqui, S., & Doody, R. S. (2009) · Alzheimers Res Ther · doi:10.1186/alzrt7 · Cited by 181 · see citing works
Combination Therapy for Alzheimerʼs Disease
Patel, L., & Grossberg, G. T. (2011) · Drugs & Aging · doi:10.2165/11591860-000000000-00000 · Cited by 93 · see citing works
Molnar, F., Man‐Son‐Hing, M., & Fergusson, D. A. (2009) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.02122.x · Cited by 91 · see citing works
Atri, A., Hendrix, S. B., Pejović, V., Hofbauer, R. K., Edwards, J., Molinuevo, J. L., & Graham, S. M. (2015) · Alzheimer s Research & Therapy · doi:10.1186/s13195-015-0109-2 · Cited by 76 · see citing works
Treatment Patterns with Antidementia Drugs in the United States: Medicare Cohort Study
Koller, D., Hua, T., & Bynum, J. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14226 · Cited by 74 · see citing works
Maxwell, C. J., Stock, K. J., Seitz, D. P., & Herrmann, N. (2014) · The Canadian Journal of Psychiatry · doi:10.1177/070674371405901203 · Cited by 64 · see citing works
A clinical registry of dementia based on the principle of epidemiological surveillance
Registry of Dementia of Girona Study Group (ReDeGi Group), Garre‐Olmo, J., Flaqué, M., Gich, J., Pulido, T. O., Turbau, J., Vallmajó, N., Viñas, M., & Pousa, S. L. (2009) · BMC Neurology · doi:10.1186/1471-2377-9-5 · Cited by 59 · see citing works
Antidementia drug use among community-dwelling individuals with Alzheimer’s disease in Finland
Taipale, H. T., Tanskanen, A. J., Koponen, M., Tolppanen, A., Tiihonen, J., & Hartikainen, S. A. (2014) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000032 · Cited by 56 · see citing works
Adherence to Cholinesterase Inhibitors in Alzheimer's Disease: A Review
Brady, R., & Weinman, J. A. (2013) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000347140 · Cited by 47 · see citing works
A population-based study of dosing and persistence with anti-dementia medications
Brewer, L., Bennett, K., McGreevy, C., & Williams, D. J. (2013) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-013-1483-y · Cited by 45 · see citing works
Continuous treatment with antidementia drugs in Germany 2003–2013: a retrospective database analysis
Bohlken, J., Weber, S., Rapp, M. A., & Kostev, K. (2015) · International Psychogeriatrics · doi:10.1017/s1041610215000654 · Cited by 36 · see citing works
Medication Adherence in Patients With Dementia
Haider, B., Schmidt, R., Schweiger, C., Forstner, T., Labek, A., & Lampl, C. (2013) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000006 · Cited by 34 · see citing works
The ICTUS Group, Gardette, V., Lapeyre‐Mestre, M., Piau, A., Gallini, A., Cantet, C., Montastruc, J., Vellas, B. J., & Andrieu, S. (2014) · CNS Drugs · doi:10.1007/s40263-013-0133-3 · Cited by 28 · see citing works
Wübbeler, M., Wucherer, D., Hertel, J., Michalowsky, B., Heinrich, S., Meyer, S., Schäfer‐Walkmann, S., Hoffmann, W. U., & Thyrian, J. R. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-0855-7 · Cited by 20 · see citing works
Withdrawal of Antidementia Drugs in Older People: Who, When and How?
Parsons, C. (2016) · Drugs & Aging · doi:10.1007/s40266-016-0384-z · Cited by 19 · see citing works
Garre‐Olmo, J., Ptacek, S. G., Calvó‐Perxas, L., Garriga, O. T., Pousa, S. L., & Eriksdotter, M. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-160098 · Cited by 19 · see citing works
Pai, M., Lai, T., Wang, W.-F., Yip, B., Yang, Y.-W., Peng, G.-S., Tsai, S.-J., & Liao, Y. (2016) · Patient Preference and Adherence · doi:10.2147/ppa.s95271 · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
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Current and Future Treatments in Alzheimer Disease: An Update
Yiannopoulou, K. G., & Papageorgiou, S. G. (2020) · Journal of Central Nervous System Disease · doi:10.1177/1179573520907397 · Cited by 966 · see citing works
Dou, K.-X., Tan, M.-S., Tan, C.-C., Cao, X.-P., Hou, X.-H., Guo, Q.-H., Tan, L., Mok, V., & Yu, J.-T. (2018) · Alzheimer's Research & Therapy · doi:10.1186/s13195-018-0457-9 · Cited by 171 · see citing works
Ruangritchankul, S., Chantharit, P., Srisuma, S., & Gray, L. (2021) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s323387 · Cited by 146 · see citing works
An update on the novel and approved drugs for Alzheimer disease
Alhazmi, H. A., & Albratty, M. (2022) · Saudi Pharmaceutical Journal · doi:10.1016/j.jsps.2022.10.004 · Cited by 122 · see citing works
Blanco-Silvente, L., Capellà, D., Garre-Olmo, J., Vilalta-Franch, J., & Castells, X. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0857-5 · Cited by 48 · see citing works
Yu, L., Chen, X., & Yu, Z. (2019) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000278 · Cited by 18 · see citing works
Imai, H., Hirai, T., Kumazawa, R., Nakagawa, S., Yonezawa, A., Matsubara, K., & Nakao, H. (2020) · PLoS ONE · doi:10.1371/journal.pone.0231226 · Cited by 16 · see citing works
Ju, C., Wong, I. C. K., Lau, W. C. Y., Man, K. K. C., Brauer, R., Ma, T., Alsharif, A. A., Alwafi, H. H., Lau, K. K., Chan, E. W., et al. (2021) · European Journal of Neurology · doi:10.1111/ene.15053 · Cited by 16 · see citing works
Prescription patterns of antidementives in a high income country: A pharmacoepidemiologic study
Wurm, R., Stamm, T., Reichardt, B., Schwarz, F. K., Parvizi, T., Silvaieh, S., König, T., Çetin, H., & Stögmann, E. (2020) · Alzheimer s & Dementia Translational Research & Clinical Interventions · doi:10.1002/trc2.12014 · Cited by 14 · see citing works
Cholinesterase inhibitors for the treatment of dementia: real-life data in Hungary
Balázs, N., Bereczki, D., Ajtay, A., Oberfrank, F., & Kovács, T. (2021) · GeroScience · doi:10.1007/s11357-021-00470-7 · Cited by 13 · see citing works
Real-World Use of Symptomatic Treatments in Early Alzheimer’s Disease
Garcia, M. J., Leadley, R. M., Lang, S., Ross, J., Vinand, E., Ballard, C. G., & Gsteiger, S. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-220471 · Cited by 11 · see citing works
Padovani, A., Falato, S., & Pegoraro, V. (2023) · Current Medical Research and Opinion · doi:10.1080/03007995.2023.2182530 · Cited by 9 · see citing works
The Impact of Disease Registries on Advancing Knowledge and Understanding of Dementia Globally
Heikal, S. A., Salama, M., Richard, Y., Moustafa, A. A., & LAWLOR, B. A. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.774005 · Cited by 9 · see citing works
Case report: a unique presentation of memantine overdose causing echolalia and hypertension
Durrani, S., & Ahmed, S. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04658-2 · Cited by 9 · see citing works
Reyes, C., Newby, D., Raventós, B., Verhamme, K. M. C., Mosseveld, M., Prieto‐Alhambra, D., Burn, E., & Duarte‐Salles, T. (2024) · Age and Ageing · doi:10.1093/ageing/afae106 · Cited by 8 · see citing works
Gutiérrez‐Abejón, E., Pedrosa-Naudín, M. A., Fernández‐Lázaro, D., Planelles, I. D., & Alvarez, E. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1425442 · Cited by 7 · see citing works
Trends in the Use of Medications and Supplements to Treat or Prevent Dementia
Stoehr, G. P., Jacobsen, E. P., Jia, Y., Snitz, B. E., & Ganguli, M. (2019) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000357 · Cited by 7 · see citing works
Determinants of antidementia drug prescription in patients older than 65: A latent class analysis
François, M., Sicsic, J., & Pelletier‐Fleury, N. (2020) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.4921 · Cited by 7 · see citing works
Becker, C., Herschung, L., Gomm, W., & Haenisch, B. (2025) · Journal of Alzheimer s Disease · doi:10.1177/13872877251319468 · Cited by 6 · see citing works
Jolliff, A. F., Loganathar, P., Holden, R. J., Linden, A., Patel, H., Lee, J. R., Ganci, A., Campbell, N., Boustani, M., & Werner, N. E. (2024) · JMIR Aging · doi:10.2196/63944 · Cited by 3 · see citing works
Living alone for people on dementia medication: related use of drugs
Zafeiridi, E., McMichael, A., Passmore, A. P., & McGuinness, B. (2020) · Aging · doi:10.18632/aging.104125 · Cited by 4 · see citing works
Rodríguez-Espinosa, N., Harmand, M. G., & Miguel, M. A. M. (2023) · Revista Española de Geriatría y Gerontología · doi:10.1016/j.regg.2023.101446 · Cited by 2 · see citing works
Gupta, P. (2024) · African Journal of Biomedical Research · doi:10.53555/ajbr.v27i4s.4758 · Cited by 1 · see citing works
Phatthanasobhon, S., Singkham, N., Na-Ek, N., Wongsalap, Y., Rattanachaisit, W., Mekkhayai, Y., Onseng, K., Muenpa, R., Chindasu, P., Winitkulchai, P., et al. (2024) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2024.105727
Wang, J., Wang, X., Zhuo, Y., Yue, J., Dong, B., Yang, X., & Li, Y. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06350-5
Melendo-Azuela, E. M., Lladó, A., Vela, E., Mariscal, S., Clèries, M., Piñol‐Ripoll, G., & Santaeugènia, S. (2025) · BMC Public Health · doi:10.1186/s12889-025-24341-4
Dementia medications and the use of psychotropic drugs: A cross-sectional study in Saudi healthcare
Hajjar, S. H., Alamri, S. H., AlFouzan, M. A., Alsaad, S. M., Rohaiem, S. N., Altamimi, T. N. A., Alodhayani, A. A., Alharkan, K. S., Albalawi, A., Almuzaen, N. A., et al. (2025) · Journal of Alzheimer s Disease · doi:10.1177/13872877251393423
The Change in Dementia Presentation During the Past Decades
Jhang, K.-M., Lee, C.-J., & Chen, Y.-C. (2026) · Springer eBooks · doi:10.1007/978-981-95-5222-1_11
Sánchez‐Juan, P., Baz, P. G., Arrieta, E., Novick, D., Díaz-Cerezo, S., Cotton, S. E., Walker, C., Trueba-Sáiz, Á., & Nuñez, M. G. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2025.1702805
Øvrebø, T. G., Sunde, A. L., Rongve, A., Kjosavik, S. R., Dalen, I., & Oesterhus, R. (2026) · Drugs - Real World Outcomes · doi:10.1007/s40801-026-00547-9
- Authors
- on behalf of the Registry of Dementias of Girona Study Group (ReDeGi Study Group), Calvó-Perxas, L., Turró-Garriga, O., Vilalta-Franch, J., Lozano-Gallego, M., de Eugenio, R., Márquez, F., Carmona, O., Gich, J., Manzano, A., Viñas, M., Roig, A. M., & Garre-Olmo, J.
- Affiliations
- Institut d'Investigació Biomèdica de Girona (ES)
- Hospital de Figueres (ES)
- Hospital Universitari de Girona Doctor Josep Trueta (ES)
- ORCID
- Carmona, Olga
- Venue
- Drugs & Aging
- Published
- 2017-03-04
- Volume
- 34
- Issue
- 4
- Pages
- 303-310
- ISSN
- 1170-229X (ISSN-L)
- 1179-1969
- OpenAlex
- W2593022701
- Cited by
- 30
- References
- 27
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 2
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drugs & Aging (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
- Keywords
- Alzheimer's disease, anti-dementia drugs, acetylcholinesterase inhibitors, memantine, prescribing patterns, dementia severity, age, drug use trends, combination therapy
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Cholinesterase Inhibitors, Drug Utilization, Female, Humans, Male, Memantine, Registries, Spain, Cohort Studies
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