TY  - JOUR
AU  - Platen, Moritz
AU  - Gläser, Eva
AU  - Dahling, Volker
AU  - Gesell, Daniela
AU  - Hauptmann, Michael
AU  - Horenkamp-Sonntag, Dirk
AU  - Koller, Daniela
AU  - Kubat, Denise
AU  - Marschall, Ursula
AU  - Riederer, Cordula
AU  - Scheibner, Hannah
AU  - Schroth, Jennifer
AU  - Swart, Enno
AU  - Michalowsky, Bernhard
TI  - Regional disparities of antidementia drug treatment in Germany: what can we learn for the new generation of Alzheimer's therapies.
JO  - Alzheimer's research & therapy
VL  - 17
IS  - 1
SN  - 1758-9193
CY  - London
PB  - BioMed Central
M1  - DZNE-2025-01365
SP  - 259
PY  - 2025
AB  - Current antidementia drugs can temporarily slow cognitive decline in Alzheimer's disease but are underused. Regional and socioeconomic disparities, including limited specialist access in rural or deprived areas, may exacerbate inequities and challenge the rollout of emerging disease-modifying therapies. This study aimed to evaluate associations between regional contextual factors and antidementia drug prescription (AD-Rx) among newly diagnosed people living with Alzheimer's disease (PlwAD) in Germany and to identify spatial clustering of prescribing patterns.This study analyzed anonymized claims data from three statutory health insurers for 53,753 PlwAD who received their first diagnosis between January 2020 and December 2022. Regions, defined by three-digit postal codes (ZIP3, n = 576), were categorized by the German Index of Socioeconomic Deprivation (GISD) quintiles and Degree of Urbanization (urban, suburban, rural). Multilevel logistic regression with random intercepts for ZIP3 was used to assess associations between receiving AD-Rx (dichotomous) and urbanization and deprivation, adjusting for age, sex, the Charlson Comorbidity Index, the long-term care level and the year of diagnosis. Global Moran's I was used to evaluate large-scale spatial clustering, and regional Moran's I was calculated to detect regional hotspots and coldspots.Overall, 64
KW  - Humans
KW  - Germany: epidemiology
KW  - Alzheimer Disease: drug therapy
KW  - Alzheimer Disease: epidemiology
KW  - Male
KW  - Female
KW  - Aged
KW  - Healthcare Disparities: statistics & numerical data
KW  - Aged, 80 and over
KW  - Rural Population
KW  - Nootropic Agents: therapeutic use
KW  - Socioeconomic Factors
KW  - Middle Aged
KW  - Alzheimer’s disease (Other)
KW  - Antidementia drug treatment (Other)
KW  - Deprivation (Other)
KW  - Disease-modifying treatments, geographical variation, spatial analysis (Other)
KW  - Healthcare disparities (Other)
KW  - Real-world data (Other)
KW  - Real-world evidence (Other)
KW  - Rural population (Other)
KW  - Nootropic Agents (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:41345718
C2  - pmc:PMC12696915
DO  - DOI:10.1186/s13195-025-01902-8
UR  - https://pub.dzne.de/record/282629
ER  -