TY - JOUR
T1 - Dementia diagnosis and osteoporosis treatment propensity
T2 - A population-based nested case-control study
AU - Knopp-Sihota, Jennifer A.
AU - Cummings, Greta G.
AU - Newburn-Cook, Christine V.
AU - Homik, Joanne
AU - Voaklander, Don
PY - 2014/1
Y1 - 2014/1
N2 - Aim: Increasing age and a diagnosis of dementia both dramatically increase the risk of serious osteoporosis-related sequela. We sought to examine the factors associated with osteoporosis treatment, in relation to dementia diagnosis, in older adults with osteoporosis. Methods: This was a population-based, retrospective, nested, case-control study utilizing administrative healthcare data from British Columbia, Canada. Community-based individuals aged ≥65 years with an osteoporosis diagnosis and continuous enrolment in the provinces' drug plan between 1991 and 2007 were eligible for inclusion. A multivariate logistic regression model was assembled to examine the relationship between dementia diagnosis, age, sex, other comorbidity, residence and osteoporosis medication dispensation. Results: Almost half of the total osteoporosis cohort (n=39452) were dispensed an osteoporosis medication during the study period. Individuals with no dementia diagnosis were dispensed a medication significantly more often than those with a diagnosis of dementia (P<0.001). Those patients with dementia (n=13315), who had been dispensed an osteoporosis drug, were more often younger, female, had not sustained a previous fracture, had≥4 comorbid conditions and lived in the most central health region (P<0.001). A diagnosis of dementia was found to be a significant negative predictor of osteoporosis drug dispensation (adjusted OR 0.55; 95% CI 0.44-0.69). Increasing comorbidity was significantly associated with receiving treatment (adjusted OR 3.30; 95% CI 2.88-3.78). Conclusion: Despite the wide availability of osteoporosis medications, our findings suggest that many older adults with a diagnosis of dementia, but not necessarily fewer comorbid conditions, were not receiving treatment.
AB - Aim: Increasing age and a diagnosis of dementia both dramatically increase the risk of serious osteoporosis-related sequela. We sought to examine the factors associated with osteoporosis treatment, in relation to dementia diagnosis, in older adults with osteoporosis. Methods: This was a population-based, retrospective, nested, case-control study utilizing administrative healthcare data from British Columbia, Canada. Community-based individuals aged ≥65 years with an osteoporosis diagnosis and continuous enrolment in the provinces' drug plan between 1991 and 2007 were eligible for inclusion. A multivariate logistic regression model was assembled to examine the relationship between dementia diagnosis, age, sex, other comorbidity, residence and osteoporosis medication dispensation. Results: Almost half of the total osteoporosis cohort (n=39452) were dispensed an osteoporosis medication during the study period. Individuals with no dementia diagnosis were dispensed a medication significantly more often than those with a diagnosis of dementia (P<0.001). Those patients with dementia (n=13315), who had been dispensed an osteoporosis drug, were more often younger, female, had not sustained a previous fracture, had≥4 comorbid conditions and lived in the most central health region (P<0.001). A diagnosis of dementia was found to be a significant negative predictor of osteoporosis drug dispensation (adjusted OR 0.55; 95% CI 0.44-0.69). Increasing comorbidity was significantly associated with receiving treatment (adjusted OR 3.30; 95% CI 2.88-3.78). Conclusion: Despite the wide availability of osteoporosis medications, our findings suggest that many older adults with a diagnosis of dementia, but not necessarily fewer comorbid conditions, were not receiving treatment.
KW - Claims data
KW - Comorbidity
KW - Dementia
KW - Older adults
KW - Osteoporosis
UR - http://www.scopus.com/inward/record.url?scp=84892366439&partnerID=8YFLogxK
U2 - 10.1111/ggi.12069
DO - 10.1111/ggi.12069
M3 - Journal Article
C2 - 23992035
AN - SCOPUS:84892366439
SN - 1444-1586
VL - 14
SP - 121
EP - 129
JO - Geriatrics and Gerontology International
JF - Geriatrics and Gerontology International
IS - 1
ER -