Universität zu Köln

Pilotto, Alberto, Polidori, Maria Cristina, Veronese, Nicola ORCID: 0000-0002-9328-289X, Panza, Francesco ORCID: 0000-0002-7220-0656, Giancristofaro, Rosa Arboretti, Pilotto, Andrea ORCID: 0000-0003-2029-6606, Daragjati, Julia, Carrozzo, Eleonora, Prete, Camilla, Gallina, Pietro, Padovani, Alessandro and Maggi, Stefania (2018). Association of Antidementia Drugs and Mortality in Community-Dwelling Frail Older Patients With Dementia: The Role of Mortality Risk Assessment. J. Am. Med. Dir. Assoc., 19 (2). S. 162 - 169. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1538-9375

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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. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pilotto, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Polidori, Maria Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Veronese, Nicola UNSPECIFIED orcid.org/0000-0002-9328-289X UNSPECIFIED Panza, Francesco UNSPECIFIED orcid.org/0000-0002-7220-0656 UNSPECIFIED Giancristofaro, Rosa Arboretti UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilotto, Andrea UNSPECIFIED orcid.org/0000-0003-2029-6606 UNSPECIFIED Daragjati, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Carrozzo, Eleonora UNSPECIFIED UNSPECIFIED UNSPECIFIED Prete, Camilla UNSPECIFIED UNSPECIFIED UNSPECIFIED Gallina, Pietro UNSPECIFIED UNSPECIFIED UNSPECIFIED Padovani, Alessandro UNSPECIFIED UNSPECIFIED UNSPECIFIED Maggi, Stefania UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-196561
DOI:	10.1016/j.jamda.2017.08.017
Journal or Publication Title:	J. Am. Med. Dir. Assoc.
Volume:	19
Number:	2
Page Range:	S. 162 - 169
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1538-9375
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MULTIDIMENSIONAL PROGNOSTIC INDEX; COMPREHENSIVE GERIATRIC ASSESSMENT; CHOLINESTERASE-INHIBITORS; ALZHEIMER-DISEASE; MEMANTINE; DONEPEZIL; PEOPLE; ADULTS; VALIDATION; STATEMENT Multiple languages Geriatrics & Gerontology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19656