P3-265: Psychoactive medication and memory impairment among members of an Alzheimer prevention registry

Studies of psychoactive medication use among older adults with dementia have demonstrated that many take medications that may cause or contribute to memory impairment; however, patterns of psychoactive medication use in cognitively normal older adults volunteering for early intervention and AD prevention studies is unknown. Objectives: (1) Describe the prevalence of psychoactive medication use among members of the Rhode Island Hospital Alzheimer Prevention Registry; and (2) investigate relationships between sedative and anticholinergic medication burden and neuropsychological test performance at baseline and the first annual follow up visit. Subjects include 207 healthy, older adult (age 55-90 years) members of the Registry without previously diagnosed cognitive disorders, and interested in volunteering for AD prevention studies. Information on self-reported medication use, history of medical and psychiatric conditions, sociodemographics, APOE genotype, and neurocognitive test results, will be obtained from the Registry database. Prescription and over-the-counter medications are classified into two categories associated with cognitive toxicity in older adults: (1) sedative, and (2) anticholinergic drugs. For each participant, the degree of exposure to drugs in each category will be estimated using the Drug Burden Index (DBI), a dose-standardized measure that has been shown to predict cognitive and functional outcomes in previous studies of community-dwelling older adults. Relationships between the DBI and cognitive outcomes will be analyzed for each category of psychoactive medication, as well as the total psychoactive medication burden (DBIsedative + DBIanticholinergic) at baseline and one year. Associations between the time-varying DBI scores and global cognitive functioning (Mattis Dementia Rating Scale-2), in addition to tests of cognitive domains (executive, attention, memory, psychomotor speed), will be analyzed with multivariable Poisson regression models, adjusted for potential confounding by indication with propensity score methods. Results will be presented in July 2015. The results of this study are of importance in developing selection criteria for AD prevention trials, because adverse cognitive effects of medications may exclude individuals who might otherwise qualify for participation. These findings also highlight the need for documenting medication use information in the databases of similar research registries that aim to recruit community-dwelling older adults concerned with brain health and aging.