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Association of Antidementia Drugs and Mortality in Community-Dwelling Frail Older Patients With Dementia: The Role of Mortality Risk Assessment
- Source :
- Journal of the American Medical Directors Association, 19(2), 162-168. Elsevier Inc.
- Publication Year :
- 2018
-
Abstract
- 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
- Subjects :
- Male
Gerontology
medicine.medical_specialty
Frail Elderly
Multidimensional assessment
antidementia drug
Lower risk
Comprehensive geriatric assessment
Risk Assessment
Article
03 medical and health sciences
0302 clinical medicine
Older patients
SDG 3 - Good Health and Well-being
Risk Factors
antidementia drugs
comprehensive geriatric assessment
Dementia
frailty
mortality
multidimensional prognostic index (MPI)
Nursing (all)2901 Nursing (miscellaneous)
Health Policy
Geriatrics and Gerontology
Internal medicine
medicine
Humans
030212 general & internal medicine
Multidimensional prognostic index (MPI)
Mortality
Geriatric Assessment
General Nursing
Aged
Retrospective Studies
Aged, 80 and over
Frailty
business.industry
Hazard ratio
General Medicine
medicine.disease
Survival Analysis
Confidence interval
Antidementia drugs
Female
Independent Living
Nursing homes
business
Risk assessment
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 15258610
- Database :
- OpenAIRE
- Journal :
- Journal of the American Medical Directors Association, 19(2), 162-168. Elsevier Inc.
- Accession number :
- edsair.doi.dedup.....718828d5d0ab83bcb60adaaf1e2e2858