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.
Keywords
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Article info
Publication history
Published online: October 12, 2017
Footnotes
Funding for this study was provided by the MPI_Age European project co-funded by the Consumers, Health, Agriculture, and Food Executive Agency (CHAFEA) in the frame of the European Innovation Partnership on Active and Healthy Ageing Second Health Program 2008–2013. The contents of this article are the sole responsibility of the above mentioned authors and can under no circumstances be regarded as reflecting the position of the European Union. The funding agencies had no role in design or conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The study was based on administrative data sets, and the participants were not identifiable to the authors.
The authors declare no conflicts of interest.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
