0000000000241463

AUTHOR

Gayan Perera

0000-0002-3414-303x

showing 4 related works from this author

Polypharmacy in people with dementia: Associations with adverse health outcomes

2018

Polypharmacy has been linked to higher risks of hospitalisation and death in community samples. It is commonly present in people with dementia but these risks have rarely been studied in this population. We aimed to investigate associations between polypharmacy and emergency department attendance, any and unplanned hospitalisation, and mortality in patients with dementia. Using a large mental health care database in South London, linked to hospitalisation and mortality data, we assembled a retrospective cohort of patients diagnosed with dementia. We ascertained number of medications prescribed at the time of dementia diagnosis and conducted multivariate Cox regression analyses. Of 4668 pati…

MaleAgingmedicine.medical_specialtyDatabases FactualPopulationBiochemistry03 medical and health sciences0302 clinical medicineEndocrinologyRisk FactorsLondonDementia; Emergency department; Hospitalisation; Mortality; Pharmacoepidemiology; PolypharmacyGeneticsmedicineHospitalisationDementiaHumans030212 general & internal medicineMortalityeducationMolecular BiologyAgedRetrospective StudiesPolypharmacyAged 80 and overeducation.field_of_studyProportional hazards modelbusiness.industryEmergency departmentPharmacoepidemiologyHazard ratioAttendanceRetrospective cohort studyCell BiologyEmergency departmentmedicine.diseaseSurvival AnalysisHospitalizationEmergency medicineMultivariate AnalysisPolypharmacyFemaleDementiabusinessEmergency Service Hospital030217 neurology & neurosurgery
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The relationship between Polypharmacy and Trajectories of Cognitive Decline in People with Dementia: a large representative cohort study

2019

Polypharmacy, defined through the number of medications prescribed, has been linked to a range of adverse health outcomes in people with dementia. It is however unclear whether a numerical threshold of concurrently prescribed drugs is a suitable predictor for cognitive decline. We aimed to test associations between polypharmacy and both short-term (six months) and long-term (three years) cognitive trajectories in patients with incident dementia. Using data from a large mental health and dementia care database in South London, a cohort of 12,148 patients (mean age = 80.7 years, 61.1% female, mean MMSE = 18.6) clinically diagnosed with dementia was identified. We determined the number of medi…

Male0301 basic medicineGerontologyAgingCognitive declineBiochemistryCohort Studies03 medical and health sciencesCognitionCommunity care0302 clinical medicineEndocrinologyA large representative cohort study.- Experimental gerontology cilt.120 ss.62-67 2019 [Soysal P. Perera G. Isik A. Onder G. Petrovic M. Cherubini A. Maggi S. Shetty H. Molokhia M. Smith L. et al. -The relationship between polypharmacy and trajectories of cognitive decline in people with dementia]mental disordersGeneticsmedicineHumansDementiaCognitive DysfunctionCognitive declineassociations between polypharmacyMolecular BiologyAgedAged 80 and overPolypharmacypeople with dementia.Mini–Mental State Examinationmedicine.diagnostic_testbusiness.industryCognition; Cognitive decline; Community care; Dementia; PolypharmacyCognitionlong-term (three years)Cell BiologyMental Status and Dementia Testsmedicine.diseaseComorbidity030104 developmental biologyCohortPolypharmacyFemaleDementiabusinessshort-term (six months)030217 neurology & neurosurgeryCohort study
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Associations of neuropsychiatric symptoms and antidepressant prescription with survival in Alzheimer's disease

2017

Objective Depression is associated with increased mortality in community samples. The use of antidepressant medication may also increase mortality, however, it is still unclear whether taking antidepressants before or after a diagnosis of dementia influences survival. Design Retrospective. Setting A cohort with a diagnosis of Alzheimer disease (AD) from a large mental health and dementia care database in South London, linked to hospitalization and mortality data. Participants Mild dementia (Mini-Mental State Examination ≥18/30) at the point of diagnosis. Measurements We ascertained antidepressant prescription, either in the 6 months before or after dementia diagnosis, and used the HoNOS65+,…

Malemedicine.medical_specialtyPediatricsDatabases FactualDementia; antidepressants; depression; mortalityKaplan-Meier EstimateNeuropsychological TestsRisk AssessmentSeverity of Illness Index03 medical and health sciencesSex Factors0302 clinical medicineAlzheimer DiseasemedicineHumansDementia030212 general & internal medicineMedical prescriptionRisk factorPsychiatryGeneral NursingDepression (differential diagnoses)AgedProportional Hazards ModelsRetrospective StudiesAged 80 and overDepressive Disorderbusiness.industryHealth PolicyHazard ratioAge FactorsGeneral MedicineMiddle AgedPrognosismedicine.diseaseSurvival AnalysismortalityAntidepressive AgentsConfidence intervalantidepressantsdepressionCohortFemaleDementiaGeriatrics and GerontologyAlzheimer's diseasebusinessdementia mortality030217 neurology & neurosurgery
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Predictors of Falls and Fractures Leading to Hospitalization in People With Dementia: A Representative Cohort Study.

2018

OBJECTIVES: Investigate predictors of falls and fractures leading to hospitalization in a large cohort of people with dementia. DESIGN: A retrospective cohort study. SETTING AND PARTICIPANTS: People with diagnosed dementia between January 2007 and March 2013, aged >65 years, were assembled using data from the Maudsley Biomedical Research Centre Case Register, from 4 boroughs in London serving a population of 1.3 million people. MEASURES: Falls and/or fractures leading to hospitalization were ascertained from linked national records. Demographic data, cognitive test scores, medications, and symptom and functioning scores from Health of the Nation Outcome Scales (HoNOS65+) were modeled in mul…

GerontologyMaleGeriatrics & Gerontology*dementiaHealth StatusPoison controlFalls fractures dementia hospital admission Alzheimer’s disease mortalityOccupational safety and healthCohort Studies*mortalityFractures Bone0302 clinical medicine*hospital admissionResidence CharacteristicsLondon030212 general & internal medicineRegistriesGeneral NursingASSOCIATIONSeducation.field_of_studyHealth PolicyAge FactorsPAINGeneral MedicinefracturesAlzheimer's diseaseHospitalizationSURVIVALFallsFemaleHEALTHLife Sciences & BiomedicineCohort studyPopulation03 medical and health sciencesSex FactorsInjury preventionmedicineDementiaHumansVascular dementiaeducationOLDER-ADULTS*FallsAgedRetrospective StudiesScience & Technologybusiness.industry*Alzheimer's diseaseMORTALITY*fracturesRetrospective cohort studymedicine.diseaseCOGNITIVE IMPAIRMENThospital admissionRISK-FACTORSAccidental FallsDementiaGeriatrics and Gerontologybusiness030217 neurology & neurosurgerydementiaJournal of the American Medical Directors Association
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