Lower Barthel Index scores predict less prescription of pharmacological therapy in elderly patients with Alzheimer disease.

AIMS: To determine the factors associated with receiving specific treatment (cholinesterase inhibitors or/and memantine) for Alzheimer disease (AD) in elderly patients.
METHODS: An observational study carried out in 289 consecutive outpatients aged >64 years with dementia. We collected data on specific AD therapy, sociodemographic variables, Barthel Index (BI), Lawton and Brody Index (LI), Mini Mental State Examination, Global Deterioration Scale (GDS), Charlson Index and the total number of drugs chronically prescribed. Patients receiving specific therapy for dementia were compared with the rest.
RESULTS: Two hundred and thirty-three (80.6%) patients were receiving specific treatment for dementia, with 197 (84.5%) receiving monotherapy and the rest (15.4%) combined therapy. The bivariate analysis showed that age, marital status, place of residence, BI and LI, cognitive status and disease severity (GDS) were factors associated with receiving specific dementia therapy. Multiple stepwise logistic regression analysis showed that a lower BI (beta = -0.25; odds ratio 0.976, 95% confidence interval = 0.966-0.986; p < 0.0001) was the only factor independently associated with not receiving specific therapy for AD.
CONCLUSIONS: Of the possible factors related to elderly patients receiving specific therapy for AD, a poor BI score was the most important factor associated with not receiving treatment. 2010 S. Karger AG, Basel.