Patterns of Medication Use among Women with Dementia

Dementia is one of the biggest global health challenges of the current generation. This

challenge is not only due to the nature of the disease but also the complexity of

managing medications among the population. The Incidence of dementia is increasing

exponentially, with a higher prevalence among women. The thesis investigated i) the

prevalence of commonly used medications among women with dementia a year before

and after a dementia diagnosis; ii) the implementation of medication reviews for

Australian women with dementia, focusing on those living in residential aged-care

(RAC) and iii) polypharmacy prevalence and polypharmacy trajectories over time

among older women with and without dementia. For this research project, survey data

from the Australian Longitudinal Study on Women's Health (ALSWH) 1921 - 1926

birth cohort were linked with government administrative datasets including the

Pharmaceutical Benefits Scheme (PBS), the Medicare Benefits Schedule (MBS), agedcare

datasets, state-based hospital datasets and the National Death Index (NDI).

Advanced analytical techniques, such as Latent Class Analysis (LCA), Generalised

Estimating Equation (GEE), logistic regressions and Group-Based Trajectory Modelling

(GBTM) were used to investigate the aims of the thesis. Findings from the studies

revealed that considerable proportions of women utilised psychotropic medications both

before and after a dementia diagnosis. Among women with dementia, the use of

psychotropic medications was higher for those with frailty and those living in RAC. The

annual medication review was more common for women with dementia in general-and

among those living in RAC in particular-when compared to women without dementia

and those not living in RAC; however, the incidence of medication review was modest,

indicating limited uptake of medication review services funded under the MBS.