Comorbidity profile of dementia patients in primary care: Are they sicker?

Cathy C. Schubert, Malaz Boustani, Christopher M. Callahan, Anthony J. Perkins, Caroline P. Carney, Christopher Fox, Frederick Unverzagt, Siu Hui, Hugh C. Hendrie

Research output: Contribution to journalArticle

167 Scopus citations

Abstract

OBJECTIVES: To compare the medical comorbidity of older patients with and without dementia in primary care. DESIGN: Cross-sectional study. SETTING: Wishard Health Services, which includes a university-affiliated, urban public hospital and seven community-based primary care practice centers in Indianapolis. PARTICIPANTS: Three thousand thirteen patients aged 65 and older attending seven primary care centers in Indianapolis, Indiana. MEASUREMENTS: An expert panel diagnosed dementia using International Classification of Diseases, 10th Revision, criteria. Comorbidity was assessed using 10 physician-diagnosed chronic comorbid conditions and the Chronic Disease Score (CDS). RESULTS: Patients with dementia attending primary care have on average 2.4 chronic conditions and receive 5.1 medications. Approximately 50% of dementia patients in this setting are exposed to at least one anticholinergic medication, and 20% are prescribed at least one psychotropic medication. After adjusting for patients' age, race, and sex, patients with and without dementia have a similar level of comorbidity (mean number of chronic medical conditions, 2.4 vs 2.3, P=.66; average CDS, 5.8 vs 6.2, P=.83). CONCLUSION: Multiple medical comorbid conditions are common in older adults with and without dementia in primary care. Despite their cholinergic deficit, a substantial proportion of patients with dementia are exposed to anticholinergic medications. Models of care that incorporate this medical complexity are needed to improve the treatment of dementia in primary care.

Original languageEnglish (US)
Pages (from-to)104-109
Number of pages6
JournalJournal of the American Geriatrics Society
Volume54
Issue number1
DOIs
StatePublished - Jan 1 2006

Keywords

  • Alzheimer's disease
  • Comorbidity
  • Dementia

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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