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AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care
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DEcIDE Research: Treatment of Dementia Among Community-Dwelling and Institutionalized Medicare Beneficiaries

In 2002, an estimated 3.4 million Medicare beneficiaries, or 8.1 percent of the Medicare population, were diagnosed with Alzheimer’s disease and related dementias (ADRD). ADRD are prevalent, devastating, and costly diseases affecting U.S. elderly residents in both community and long-term care (LTC) settings. Between 50 percent and 75 percent of residents in nursing homes have dementia, and as many as 75 percent of all persons with dementia will eventually reside in a nursing home.

People with ADRD who reside in the community may tend to receive different treatment for the condition than people in LTC settings. Examining rates of use of dementia drugs and behavioral agents is one way to gain insight into such differences. Clinical trials of treatments for dementia have mostly been conducted in community settings, and the applicability of these trial results to LTC settings may be limited if the treatment patterns differ substantially from those in the community. In order to fill this gap, the EHC Program commissioned the DEcIDE Center at the University of Maryland at Baltimore to establish nationally representative estimates of the use of agents to treat ADRD and related behavioral symptoms among Medicare beneficiaries and to describe medication use by residential status and other patient characteristics.

The study found that, although there is little difference in the proportions receiving anti-dementia drugs across residential settings, the use of atypical antipsychotics, especially risperidone, olanzapine, and quetiapine, was much higher in LTC settings (21.0 percent, 11.9 percent, and 7.1 percent, respectively) than in the community (5.1 percent, 4.0 percent, and 2.3 percent).

You can view the complete DEcIDE report, "Treatment of Dementia Among Community-Dwelling and Institutionalized Medicare Beneficiaries."