Disparities in Alzheimer’s disease drug therapy initiation, and associated effects on disease progression

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Date and Time: 
Thursday, December 8, 2016
12:00 pm – 1:00 pm
Speaker: 
Douglas Barthold
Schaeffer Center, USC
Abstract: 

In this project, currently in the preliminary analysis stage, I am examining the use of four drugs commonly prescribed to Alzheimer’s disease (AD) and other dementia patients: donepezil, galantamine, memantine, and rivastigmine. Given evidence that racial and ethnic minorities are less adherent to AD treatment guidelines, I am investigating the factors that may lead to these differences, including insurance plan characteristics, access to specialists, and demographic and regional trends. I am also examining the consequences of these treatment disparities. For example, if an AD patient initiates drug treatment a year later than recommended, does this accelerate their progression to a severely advanced stage of the disease, as evidenced by the need for high-level care or nursing home admission? Does it accelerate their eventual mortality? There are number of methodological concerns to be addressed, including endogenous treatment variation, measurement error in the timing of AD onset, and measurement error in the progression of the condition. Despite these difficulties, examination of these questions is critical for understanding and reducing the multifaceted and disparate burden of AD.