37. EXAMINING PSYCHOTROPIC MEDICATION, SOCIAL FACTORS, NORMAL PRESSURE HYDROCEPHALUS AND MILD COGNITIVE IMPAIRMENT IN PATIENTS WITH ALZHEIMER DEMENTIA: A RETROSPECTIVE COHORT ANALYSIS.

Abstract

Introduction

Despite tauhe significant burden of Alzheimer's Dementia (AD) with Normal Pressure Hydrocephalus (NPH) and Mild Cognitive Impairment (MCI), placed on the aging population, their loved ones, and healthcare systems, these conditions remain under-researched. The overlap of NPH and MCI symptoms in persons with AD presents challenges for diagnosis, however, timely and effective management of these comorbidities can help prevent the progression to severe dementia. This study aims to examine the relationship between sociodemographic factors and psychotropic medication use in AD patients diagnosed with NPH and MCI, using the Social Determinants of Health (SDH) model.

Methods

The study analyzed 33,735 patients diagnosed with MCI (n=33,064) or NPH (n=671) between February 2016 and August 2021 at Prisma Health-Upstate South Carolina. Multivariable logistic regression identified key factors associated with NPH and MCI, including age, race, and medication use.

Results

NPH patients were older (69.38 ± 16.42 vs. 63.19 ± 21.78 years) and predominantly White (92.1% vs. 80.7%). Tobacco use (OR = 1.175, 95% CI, 1.004-1.375) and buspirone use (OR = 1.415, 95% CI, 1.116-1.794) were positively associated with NPH while being Black (OR = 0.388, 95% CI, 0.277-0.542) and risperidone use (OR = 0.217, 95% CI, 0.103-0.459) were associated with MCI. Sex-stratified analyses revealed that men with NPH were more likely to use SSRIs, while women were more likely to use memantine and buspirone.

Conclusions

The SDH framework highlighted disparities in diagnosis, revealing that White patients with AD are more likely to be diagnosed with NPH, potentially due to better access to healthcare. These findings emphasize the need for targeted interventions that address social factors, improve access to psychotropic medications, and reduce healthcare disparities to enhance outcomes for AD patients with NPH and MCI.