Böcker av Kailash Thapaliya

Dementia is one of the biggest global health challenges of the current generation. Thischallenge is not only due to the nature of the disease but also the complexity ofmanaging medications among the population. The Incidence of dementia is increasingexponentially, with a higher prevalence among women. The thesis investigated i) theprevalence of commonly used medications among women with dementia a year beforeand after a dementia diagnosis; ii) the implementation of medication reviews forAustralian women with dementia, focusing on those living in residential aged-care(RAC) and iii) polypharmacy prevalence and polypharmacy trajectories over timeamong older women with and without dementia. For this research project, survey datafrom the Australian Longitudinal Study on Women's Health (ALSWH) 1921 - 1926birth cohort were linked with government administrative datasets including thePharmaceutical Benefits Scheme (PBS), the Medicare Benefits Schedule (MBS), agedcaredatasets, state-based hospital datasets and the National Death Index (NDI).Advanced analytical techniques, such as Latent Class Analysis (LCA), GeneralisedEstimating Equation (GEE), logistic regressions and Group-Based Trajectory Modelling(GBTM) were used to investigate the aims of the thesis. Findings from the studiesrevealed that considerable proportions of women utilised psychotropic medications bothbefore and after a dementia diagnosis. Among women with dementia, the use ofpsychotropic medications was higher for those with frailty and those living in RAC. Theannual medication review was more common for women with dementia in general-andamong those living in RAC in particular-when compared to women without dementiaand those not living in RAC; however, the incidence of medication review was modest, indicating limited uptake of medication review services funded under the MBS.