Magnier V, Flipon E, Godefroy O, Ganry O, Dupuy-Sonntag D, Rosa A.

Service de Neurologie et Laboratoire de Neurosciences et Pathologies
(FRE CNRS 2726).

INTRODUCTION: Despite numerous advances in the management of patients
with Alzheimer's disease (AD), the proportion of patients treated
according to current recommendations remains unknown. METHODS: In order
to examine this point, we performed a study assessing the proportion of
AD patients receiving one acetylcholinesterase inhibitor. This study
was performed in Picardy (1.9 millions of inhabitants) in 2000 and
2001. The number of patients receiving one acetylcholinesterase
inhibitor (tacrine, donepezil, rivastigmine and galantamine) was
determined using data from health insurance and from pharmaceutical
companies. RESULTS: The prevalence of AD was estimated to vary from
10751 patients in 2000, to 10990 in 2001. The number of treated
patients was 1798 in 2000 and 2572 in 2001 and this corresponded to
16.7 percent (95CI: 2.5) and 23.4 percent (95CI: 3.4) of prevalent
cases, respectively. Following the exclusion of patients with moderate
to severe AD (estimated to represent 25 percent of patients), the
proportion of treated patients reached 22.4 percent (95CI: 2.3) in 2000
and 31.3 percent (95CI: 3.1) in 2001. CONCLUSIONS: Despite a
significant increase between 2000 and 2001, this study shows that less
than a third of AD patients with mild to moderate dementia were treated
with acetylcholinesterase inhibitors. Although numerous factors might
have affected our estimations, this study shows that effective care of
AD patients remains largely insufficient.

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