6533b86efe1ef96bd12cc95c
RESEARCH PRODUCT
Association of Antidementia Drugs and Mortality in Community-Dwelling Frail Older Patients With Dementia: The Role of Mortality Risk Assessment
A. PilottoM. C. PolidoriN. VeroneseF. PanzaR. Arboretti GiancristofaroA. PilottoJ. DaragjatiE. CarrozzoC. PreteP. GallinaA. PadovaniS. MaggiA. Cruz-jentoftM. DurandoL. FerrucciL. FratiglioniF. Mattace-rasoM. PaccalinG. RuppeR. -J. SchulzE TopinkovaG. TrifiròA. -K. WelmerMultidimensional Prognostic Index (Mpi)_age Project Investigatorssubject
MaleGerontologymedicine.medical_specialtyFrail ElderlyMultidimensional assessmentantidementia drugLower riskComprehensive geriatric assessmentRisk AssessmentArticle03 medical and health sciences0302 clinical medicineOlder patientsSDG 3 - Good Health and Well-beingRisk Factorsantidementia drugs; comprehensive geriatric assessment; Dementia; frailty; mortality; multidimensional prognostic index (MPI); Nursing (all)2901 Nursing (miscellaneous); Health Policy; Geriatrics and GerontologyInternal medicinemedicineHumansDementia030212 general & internal medicineMultidimensional prognostic index (MPI)MortalityGeriatric AssessmentNursing (all)2901 Nursing (miscellaneous)General NursingAgedRetrospective StudiesAged 80 and overFrailtybusiness.industryHealth PolicyHazard ratioGeneral Medicinemedicine.diseaseSurvival AnalysisConfidence intervalAntidementia drugs; Comprehensive geriatric assessment; Dementia; Frailty; Mortality; Multidimensional prognostic index (MPI); Nursing (all)2901 Nursing (miscellaneous); Health PolicyAntidementia drugsFemaleDementiaIndependent LivingGeriatrics and GerontologyNursing homesbusinessRisk assessment030217 neurology & neurosurgerydescription
Objective: To evaluate whether treatment with antidementia drugs is associated with reduced mortality in older patients with different mortality risk at baseline. Design: Retrospective. Setting: Community-dwelling. Participants: A total of 6818 older people who underwent a Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA) evaluation to determine accessibility to homecare services or nursing home admission from 2005 to 2013 in the Padova Health District, Italy were included. Measurements: Mortality risk at baseline was calculated by the Multidimensional Prognostic Index (MPI), based on information collected with the SVaMA. Participants were categorized to have mild (MPI-SVaMA-1), moderate (MPI-SVaMA-2), and high (MPI-SVaMA-3) mortality risk. Propensity score-adjusted hazard ratios (HR) of 2-year mortality were calculated according to antidementia drug treatment. Results: Patients treated with antidementia drugs had a significant lower risk of death than untreated patients (HR 0.82; 95% confidence interval [CI] 0.73–0.92 and 0.56; 95% CI 0.49–0.65 for patients treated less than 2 years and more than 2 years treatment, respectively). After dividing patients according to their MPI-SVaMA grade, antidementia treatment was significantly associated with reduced mortality in the MPI-SVaMA-1 mild (HR 0.71; 95% CI 0.54–0.92) and MPI-SVaMA-2 moderate risk (HR 0.61; 95% CI 0.40–0.91, matched sample), but not in the MPI-SVaMA-3 high risk of death. Conclusions: This large community-dwelling patient study suggests that antidementia drugs might contribute to increased survival in older adults with dementia with lower mortality risk. © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-02-01 |