SP12-92: Gender Disparities in Receipt of Anti-dementia Medications among Medicare Beneficiaries in the U.S.
University of South Carolina United States
Little is known about the receipt of anti-dementia medications between male and female patients with Alzheimer’s disease and related diseases (ADRD). We aimed to examine the gender disparities in the use of anti-dementia medications among Medicare beneficiaries with ADRD in the U.S.
The 2016 Medicare Current Beneficiary Survey (MCBS) data were used. Anti-dementia medications included cholinesterase inhibitors and memantine. Descriptive analyses and multivariate logistic regressions were implemented to determine the possible gender disparities in receipt of medications.
The possible differences in the management of ADRD by gender remain unknown despite the extensive literature documenting differences between men and women in brain structure and function over the lifespan. This research was conducted using a cross-sectional study design with Medicare Current Beneficiary Surveys (MCBS) from 2016. MCBS is a nationally representative sample of the Medicare claims data, which is linked to survey data and maintained by the Centers for Medicare and Medicaid Services (CMS). Patients with ADRD diagnoses were identified by ICD-10-CM (diagnosis) codes; anti-dementia medications users were identified by the use of at least one prescriptions of cholinesterase inhibitors and memantine in 2016. A total of 972 (6.6%) patients with ADRD were identified out of 14,778 eligible Medicare beneficiaries. Descriptive analyses showed significant differences in age in terms of the use of anti-dementia medications (P = 0.000). After controlling for covariates (age, gender, race, income, education, living region) using multivariable logistic regressions, we found that females with ADRD were significantly more likely to receive anti-dementia medications compared to males (OR= 1.78, 95% CI: 1.23-1.40, P=0.002).
The available effective approved treatments for ADRD include cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and the NMDA receptor antagonists (memantine). The use of these medications is essential in controlling the symptoms of patients with ADRD. Our study found that gender disparities exist in the receipt of anti-dementia medications among Medicare beneficiaries with ADRD in the United States. Specifically, females with ADRD were almost 2 times more likely to receive anti-dementia medications compared to their male counterparts. The gender disparities refer to a combination of environmental, social, and cultural differences between women and men. Gender is rooted in biology, but it is primarily shaped by environment and experience. Our findings from this study warrant the need to plan programs of care to support both women and men living with ADRD, their families, and communities. Future strategies and approaches to find barriers of prescribing, receiving and adhering to anti-dementia medications by gender should include differences in longevity, biology, cognition, and social roles and environment, and are likely to vary in degrees and interact in ways that are either known and unknown.