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20% of elderly at least 85 taking anti-dementia drug despite lack of data on effects

TOKYO -- Roughly 20 percent of Japanese people aged 85 or older are using a drug that slows down the progression of dementia even though the effectiveness of the medication for the age group is unknown, according to an Institute for Health Economics and Policy research team report published in the International Journal of Geriatric Psychiatry .

There are an estimated 5 million dementia patients in Japan, but this is the first survey to describe the prescription of the medication in detail. As the risk for side effects increases along with the advancing age of patients, the team called for academic societies to revise their advisability guidelines and cut back on the use of the medication.

The research team used the national databases on medical fee receipts, specific health checkups and other medical information and analyzed the 1,733,916 cases where anti-dementia drugs were prescribed during the one-year period beginning in April 2015. It was found that the percentage of the total population being prescribed the medication grew higher with age, and reached 17 percent for elderly patients 85 or older. In addition, 47 percent of the total amount of the drug prescribed during that one year period was for those aged 85 or older.

There are few examples of such studies in other countries, but in Germany, anti-dementia drugs are prescribed to only 20 percent of dementia patients aged 85 or older, highlighting Japan's relatively high rate of prescribing such drugs. One reason for this is thought to be the Japanese Society of Neurology's treatment-related guidelines making a strong push for the medication to be prescribed to Alzheimer's disease patients. Still, while the society's academic evidence is mainly based on those under the age of 85, there is little evidence of the effectiveness of the drug for those 85 and older.

"There is a gap between the many patients 85 and older who are actually taking the medicine and the age group for which there is evidence of effectiveness. We simply don't know how effective the drug is for those 85 and older," said team member Yasuyuki Okumura, chief researcher at the Tokyo Metropolitan Institute of Medical Science. "Due to the increased risk of side effects as patients get older, there is a need for domestic academic society advisability guidelines to be weakened or to limit the strong push for the prescription of the drug to only a certain age group," he added.

(Japanese original by Toshiyasu Kawauchi, Medical Welfare News Department)

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