THE USE OF ACETYL CHOLINESTERASE INHIBITORS AND MEMANTINE IN NURSING HOME RESIDENTS

Aim. Although a high proportion of elderly nursing home residents suffer from Alzheimer's disease (AD), data from the literature indicate that they are only rarely treated with Acetyl Cholinesterase Inhibitors (ChEls) or memantine. The aim of this study was to describe the use of ChEls or memantine by elderly residents in nursing homes, suffering from AD and to document who might qualify for pharmacological treatment according to the Belgian reimbursement rules. Method. Descriptive data was collected from 11 nursing homes through a standardized questionnaire consisting of a general section for nurses and a specific medical section for general practitioners (GP). All residents (N=1032) from these institutions were eligible for inclusion in the study; 718 (69.6%) questionnaires were completed by the nurses of which 533 (51.6%) were also completed by the GP's. Results. AD was diagnosed in 29.4% (n=211) of the residents of whom 56.4% (n=119) did not receive an anti-AD treatment, although nearly all of these patients fulfilled the Belgian requirements for reimbursement of ChEls or memantine. The mental status of the residents was often incompletely documented, but it can be estimated that at least an additional 30.1% (n=216) of all screened residents might possibly qualify for reimbursement of ChEls or memantine. Conclusions. Less than half of the AD patients in nursing homes receive ChEls or memantine and approximately one third of the residents could possibly qualify for reimbursement. Many residents with cognitive deficits remain undetected and undiagnosed and consequently do not receive appropriate treatment.