Treatment Practices of Mild Cognitive Impairment in California Alzheimer's Disease Centers

OBJECTIVES: To examine "real world" treatments for patients with mild cognitive impairment (MCI). DESIGN: Cross-sectional. SETTING: California Department of Public Health Alzheimer's Disease (AD) Research Centers of California. PARTICIPANTS: Five hundred seventy-eight patients diagnosed with MCI. MEASUREMENTS: All patients underwent comprehensive neurological and neuropsychological evaluations. Logistic regression models were used to determine patient characteristics associated with use of anti-AD medications, statins, antioxidants, and folic acid. RESULTS: One hundred sixty-six patients (28.7%) were taking anti-AD medications; use was associated with greater functional impairment, higher education, MCI subtype, and older age (P<.05 for all). Two hundred fifty-two patients (43.6%) were taking statins; use was associated with diabetes mellitus, hypertension, myocardial infarct, male sex, and MCI subtype (P<.05 for all). One hundred fifteen patients (19.9%) were taking antioxidants; use was associated with higher education and diabetes mellitus and varied according to site (P<.05 for all). Thirty-seven patients (6.4%) were taking folic acid; use was associated with nonwhite race, male sex, and greater functional impairment (P<.05 for all). CONCLUSION: This study suggests that patients with MCI are frequently being treated with "off label" cholinesterase inhibitors and memantine, as well as other possible cognition-enhancing drugs. Further investigation of the effect of treatment patterns on the clinical course of MCI is needed.