+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Statin discontinuation in nursing home residents with advanced dementia



Statin discontinuation in nursing home residents with advanced dementia



Journal of the American Geriatrics Society 62(11): 2095-2101



To describe patterns of, and factors associated with, statin use and discontinuation in nursing home (NH) residents progressing to advanced dementia and followed for at least 90 days. Retrospective inception cohort using a dataset linking 2007 to 2008 Minimum Data Set (MDS) to Medicare denominator and Part D files. All NHs in five states (Minnesota, Massachusetts, Pennsylvania, California, Florida). NH residents with dementia. Residents who developed advanced dementia were observed from baseline (date of progression to very severe cognitive impairment with eating problems) and followed for at least 90 days to statin discontinuation or death. Logistic regression was used to identify baseline factors associated with statin use. Cox proportional hazard regression was used to identify factors associated with time to statin discontinuation. Of 10,212 residents, 16.6% (n = 1,699) used statins. Greater odds of statin use were associated with having diabetes mellitus (adjusted odds ratio (AOR) = 1.24, 95% confidence interval (CI) = 1.09-1.40), stroke (AOR = 1.31, 95% CI = 1.16-1.48), and hypertension (AOR = 1.35, 95% CI = 1.18-1.54); hospice enrollment was associated with lower odds (AOR = 0.75, 95% CI = 0.64-0.89). In follow-up, 37.2% (n = 632) discontinued statins. Median time to discontinuation was 36 days (interquartile range 12-110 days). Shorter time to discontinuation was associated with hospitalization in past 30 days (adjusted hazard ratio (AHR) = 1.67, 95% CI = 1.40-1.99) and more daily medications (AHR = 1.02, 95% CI = 1.01-1.04). When statins were discontinued, 15.0% (n = 95) of residents stopped only statins, and 47.5% (n = 300) stopped at least one other medication. Most NH residents who use statins at the time of progression to advanced dementia continue use in follow-up.

(PDF emailed within 0-6 h: $19.90)

Accession: 055911064

Download citation: RISBibTeXText

PMID: 25369872

DOI: 10.1111/jgs.13105


Related references

The advanced dementia prognostic tool: a risk score to estimate survival in nursing home residents with advanced dementia. Journal of Pain and Symptom Management 40(5): 639-651, 2011

Reporting Dementia on Hospice Claims of Nursing Home Residents Dying With Advanced Dementia (312-C). Journal of Pain and Symptom Management 43(2): 340-0, 2012

Skilled nursing facility admissions of nursing home residents with advanced dementia. Journal of the American Geriatrics Society 61(10): 1645-1650, 2013

Medication use in nursing home residents with advanced dementia. International Journal of Geriatric Psychiatry 23(5): 490-496, 2007

Influence of hospice on nursing home residents with advanced dementia who received Medicare-skilled nursing facility care near the end of life. Journal of the American Geriatrics Society 60(11): 2035-2041, 2013

Estimating prognosis for nursing home residents with advanced dementia. JAMA 292(13): 1553; Author Reply 1553-4, 2004

Daily medication use in nursing home residents with advanced dementia. Journal of the American Geriatrics Society 58(5): 880-888, 2010

Predictors of mortality in nursing home residents with advanced dementia. American Journal of Alzheimer's Disease and Other Dementias 25(5): 439-445, 2010

Medicare expenditures among nursing home residents with advanced dementia. Archives of Internal Medicine 171(9): 824-830, 2011

Patterns of antimicrobial use among nursing home residents with advanced dementia. Archives of Internal Medicine 168(4): 357-362, 2008

Hospital transfers of nursing home residents with advanced dementia. Journal of the American Geriatrics Society 60(5): 905-909, 2012

Hospice use and outcomes in nursing home residents with advanced dementia. Journal of the American Geriatrics Society 58(12): 2284-2291, 2011

Quality of life in nursing home residents with advanced dementia. Journal of the American Geriatrics Society 58(12): 2394-2400, 2011

Opioid Prescription Use in Nursing Home Residents with Advanced Dementia. Pain Medicine 20(1): 50-57, 2017

Silent and invisible; nursing home residents with advanced dementia. Journal of Nutrition, Health & Aging 11(6): 484-488, 2007