Characteristics of patients misdiagnosed with Alzheimer’s disease and their medication use: an analysis of the NACC-UDS database

BMC Geriatrics

Research Article

Andrew Siderowf¹  Thomas G Beach²  David L Roth³  Tolulope Fafowora³  Joseph E Gaugler⁴  Haya Ascher-Svanum⁵ 

[1] Avid Radiopharmaceuticals Inc, Philadelphia, PA, USA;Banner Sun Health Research Institute, Sun City, AZ, USA;Center on Aging and Health, School of Medicine, Johns Hopkins University, Baltimore, MD, USA;Center on Aging, School of Nursing, University of Minnesota, Minneapolis, MN, USA;Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA;

关键词: Alzheimer disease;    Diagnosis;    Misdiagnosis;    Autopsy;    Neuropathology;   

DOI  :  10.1186/1471-2318-13-137

 received in 2013-07-15, accepted in 2013-12-17,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThis study compared individuals whose clinical diagnosis of Alzheimer’s disease (AD) matched or did not match neuropathologic results at autopsy on clinical and functional outcomes (cognitive impairment, functional status and neuropsychiatric symptoms). The study also assessed the extent of potentially inappropriate medication use (using potentially unnecessary medications or potentially inappropriate prescribing) among misdiagnosed patients.MethodsLongitudinal data from the National Alzheimer’s Coordinating Center Uniform Data Set (NACC-UDS, 2005–2010) and corresponding NACC neuropathological data were utilized to compare 88 misdiagnosed and 438 accurately diagnosed patients.ResultsFollowing adjustment of sociodemographic characteristics, the misdiagnosed were found to have less severe cognitive and functional impairment. However, after statistical adjustment for sociodemographics, dementia severity level, time since onset of cognitive decline and probable AD diagnosis at baseline, the groups significantly differed on only one outcome: the misdiagnosed were less likely to be depressed/dysphoric. Among the misdiagnosed, 18.18% were treated with potentially inappropriate medication. An additional analysis noted this rate could be as high as 67.10%.ConclusionsFindings highlight the importance of making an accurate AD diagnosis to help reduce unnecessary treatment and increase appropriate therapy. Additional research is needed to demonstrate the link between potentially inappropriate treatment and adverse health outcomes in misdiagnosed AD patients.

【 授权许可】

CC BY   
© Gaugler et al.; licensee BioMed Central Ltd. 2013