Date of Award:

5-2017

Document Type:

Thesis

Degree Name:

Master of Science (MS)

Department:

Psychology

Committee Chair(s)

JoAnn T. Tschanz

Committee

JoAnn T. Tschanz

Committee

Gail B. Rattinger

Committee

M. Scott DeBerard

Abstract

Dementia-related diseases are progressive neurological disorders that can affect a person’s cognition and functional abilities, and also result in mental health symptoms commonly called neuropsychiatric symptoms (NPS). To date, the most common pharmacological treatments for dementia, “antidementia” medications, delay the progression of the cognitive and functional symptoms of the condition. Studies of the effects of antidementia medications on NPS show varying results. Presence of NPS can also affect the amount of time caregivers provide care with persons with dementia, which can affect informal costs of the condition. This project used extant data from the longitudinal, population-based Cache County Study on Memory and Aging (CCSMA; 1994-2007) and the Dementia Progression Study (DPS; 2002-2013), which included permanent residents aged 65 years and above in 1995 in Cache County, Utah. Both of these studies were funded by grants through the National Institute on Aging, with participants and caregivers receiving $25 for each visit. Linear mixed models were used to assess the association between antidementia medications with informal costs and NPS. The first study examined whether use of antidementia medications was associated with a decrease in informal costs. The median daily informal cost of care by dementia severity was as follows: cost for mild dementia was $9.92, cost for moderate dementia was $30.02, and cost for severe dementia was $46.99. Antidementia medication use was not associated with informal costs (expβ = .79, p = .090); however, when restricting the sample to only the participants who were of mild dementia severity at baseline, antidementia medications were associated with a 28% decrease in informal costs (p = .039).

The second study evaluated if antidementia medications was associated with a decrease in NPS. Use of antidementia medications was associated with a 28% increase in NPS (expβ = 1.28, p < .001). However, this association was no longer significant with the inclusion of covariates, in particular, the use of psychotropic medications. Use of psychotropic medications was significantly associated with a 30% increase in NPS. Compared to mild dementia severity, moderate CDR was significantly associated with a 49% increase in NPS and severe CDR was significantly associated with a 60% increase in NPS. Overall, the use of antidementia medications may not significantly reduce informal costs or NPS. These studies suggest that persons who use antidementia (and psychotropic medications) are more likely to be experiencing more severe symptoms of dementia. Future work exploring patterns in the initiation and duration of use may be helpful to further examine the potential beneficial effects of these treatments.

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