A high prevalence of depression among older individuals with dementia is prompting researchers at the University of Arizona College of Pharmacy and Banner Alzheimer's Institute to investigate depression treatment among this population.
The objective of the study is to provide real-world evidence for health-care providers, patients and caregivers to make informed decisions about treating depression among older adults with dementia. Findings from this study also have the potential to significantly influence standards of depression treatment for these individuals.
Sandipan Bhattacharjee, PhD, UA assistant professor of pharmacy, received $153,500 from the National Institute of Mental Health to lead the study which began this August and extends through July 2019. No study to date has evaluated the appropriateness and outcomes of depression treatment among older adults with dementia and depression in real-world scenarios.
"Behavioral problems, including depression, are a leading cause of health-care expenditures, nursing home placement and caregiver burden in dementia," said Dr. Bhattacharjee, the study's principal investigator. "Getting appropriate treatment for depression among patients diagnosed with dementia can significantly reduce heath-care costs while improving quality of life for patients."
Clinicians long have known that a tie exists between depression and dementia, as both conditions display similar symptoms in patients, including loss of interest, apathy, reduced energy and difficulty with concentration. When evaluating patients with new concerns about memory loss, it is imperative for clinicians to recognize significant depression.
"Depression is one of the truly reversible conditions that can be confused with dementia, and if treated adequately, memory can improve," said William Burke, MD, director of the Stead Family Memory Center at Banner Alzheimer's Institute in Phoenix and co-investigator for the study.
This research will be conducted using Medicare claims date from 2011 to 2013 for adults age 65 and older who were diagnosed with dementia and depression. The research aims to:
- Quantify the extent and identify predictors of inappropriate antidepressant use;
- Determine the degree and predictors of patient adherence to recommended treatement plans during the first 4-8 months of treatement;
- Examine health outcomes and expenditures associated with recommended treatment plans.
Dr. Bhattacharjee said there is much information to glean from this large data set.
"We are looking at all of the predictors that may contribute to inappropriate depression treatment - such as patients receiving medications identified as inappropriate for use among individuals with dementia. We also are looking at outcomes associated with appropriate treatment, including demographics, co-morbidity of medical conditions, geographic location, patient adherence to treatment, prescribing physician patterns and any other themes that emerge from our research."
Apart from providing real-world evidence of depression treatment effectiveness, findings from the study have the potential to influence national guidelines for treating depression among older adults with dementia.
"This is an area we need to know more about. While we don't have a cure for dementia or other neurocognitive diseases like Alzheimer's, we do have treatment for depression," said Dr. Burke. "The goal of treatment for this population is finding solutions that have an impact on quality of life."
Other investigators on this study include Daniel Malone, PhD, Jeannie Lee, PharmD, and Jenny Lo-Ciganic, PhD, with the Department of Pharmacy Practice and Science of the UA College of Pharmacy.
This research is supported by the National Institute of Mental Health of the National Institutes of Health under award No. 1R03MH114503-01.
About the University of Arizona College of Pharmacy
Established in 1947, the College of Pharmacy was the first health sciences college at the University of Arizona and is celebrating its 70th anniversary this year. Educating pharmacists and pharmaceutical scientists, the college participates in many interprofessional educational and research collaborations throughout Arizona and globally. It is ranked among the premier colleges of pharmacy in the United States and is often among the top 20 colleges of pharmacy in terms of external funding for research, including funding from the National Institutes of Health. For more information, visit pharmacy.arizona.edu.
About the University of Arizona Health Sciences
The University of Arizona Health Sciences (UAHS) is the statewide leader in biomedical research and health professions training, with two Colleges of Medicine (Phoenix and Tucson), College of Nursing, College of Pharmacy and Mel and Enid Zuckerman College of Public Health. The UA Health Sciences colleges provide cutting-edge health education, research, patient care and community outreach services, directly impacting the state of Arizona and the greater Southwest region. For more informatin: uahs.arizona.edu. Follow us: Facebook | Twitter | YouTube | LinkedIn.
About Banner Alzheimer's Institute
Through its research and care, Banner Alzheimer's Institute is dedicated to the goal of ending Alzheimer's disease without losing another generation. Founded in 2006 by Banner Health, one of the country's largest nonprofit health care systems, BAI has a three-fold focus: to conduct revolutionary studies in the detection, treatment and prevention of Alzheimer's; to set a national standard of patient and family care; and to forge scientific collaborations that bring together institutions and disciplines internationally. For more information, visit www.banneralz.org.