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Who will be eligible? An investigation of the dementia population eligible for cholinesterase treatment following the change in NICE guidance

Matthews, Fiona E.; Muniz-Terrera, Graciela; McKeith, Ian; Brayne, Carol

Authors

Graciela Muniz-Terrera

Ian McKeith

Carol Brayne



Abstract

Objectives: Investigate the impact of the changes in eligibility within England and Wales (E&W) for prescription within the UK National Health Service for treatment of Alzheimer's disease (AD). Methods: A population-based study in England and Wales with 13 004 individuals measured with MMSE at baseline was used to examine the distributions of individuals within eligibility criteria. Information obtained from informants enabled classification of the study defined dementia cases to ICD10 diagnosis of subtype (AD, dementia with vascular risk, both or other). Results: Fifty six per cent of dementia patients (representing 323 000 individuals in E&W) fall into the new MMSE criteria band. A further 120 000, 20% of dementia patients, are estimated to have disease that is considered too mild for treatment. Further examination of type of dementia showed that those with mixed AD and vascular dementia had similar proportions of dementia cases within the treatable MMSE group as the subgroup with AD alone, though with mixed disease individuals more often score below the lower threshold. There is substantial instability in the eligibility groupings over a short time period. Conclusions: The population impact of new NICE criteria of excluding high MMSE scores is to exclude one in five individuals with AD and a further one in ten of those with a mixed disease. Changing the guidance has almost balanced the loss of treatment for the high MMSE group (13%) with the introduction of treatment for those scoring 10/11 (11%). Copyright © 2009 John Wiley & Sons, Ltd.

Citation

Matthews, F. E., Muniz-Terrera, G., McKeith, I., & Brayne, C. (2010). Who will be eligible? An investigation of the dementia population eligible for cholinesterase treatment following the change in NICE guidance. International journal of geriatric psychiatry, 25(7), 719-724. https://doi.org/10.1002/gps.2413

Journal Article Type Article
Publication Date Jul 1, 2010
Deposit Date Dec 8, 2023
Journal International Journal of Geriatric Psychiatry
Print ISSN 0885-6230
Electronic ISSN 1099-1166
Publisher Wiley
Volume 25
Issue 7
Pages 719-724
DOI https://doi.org/10.1002/gps.2413
Public URL https://hull-repository.worktribe.com/output/4455031