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Statin discontinuation in nursing home residents with advanced dementia
Tjia J, Cutrona SL, Peterson D, Reed G, Andrade SE, Mitchell SL.. Journal of the American Geriatrics Society, 2014-11-04
Topic: Risk, prevention and care in population studies
Objectives 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. Design Retrospective inception cohort using a dataset linking 2007 to 2008 Minimum Data Set (MDS) to Medicare denominator and Part D files. Setting All NHs in five states (Minnesota, Massachusetts, Pennsylvania, California, Florida). Participants NH residents with dementia. Measurements 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. Results 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. Conclusion Most NH residents who use statins at the time of progression to advanced dementia continue use in follow-up.
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APA 7th
Tjia, J., Cutrona, S. L., Peterson, D., Reed, G., Andrade, S. E., & Mitchell, S. L. (2014). Statin discontinuation in nursing home residents with advanced dementia. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.13105
Vancouver
Tjia J, Cutrona SL, Peterson D, Reed G, Andrade SE, Mitchell SL. Statin discontinuation in nursing home residents with advanced dementia. Journal of the American Geriatrics Society. 2014. doi:10.1111/jgs.13105. PMID: 25369872.
BibTeX
@article{tjia2014-25369872,
author = {Tjia, J. and Cutrona, S. L. and Peterson, D. and Reed, G. and Andrade, S. E. and Mitchell, S. L.},
title = {{Statin discontinuation in nursing home residents with advanced dementia}},
journal = {Journal of the American Geriatrics Society},
year = {2014},
doi = {10.1111/jgs.13105},
pmid = {25369872},
url = {https://doi.org/10.1111/jgs.13105}
}
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Key findings
- Objectives 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.
- 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.
- Results 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).
Study details
- Participants1,699
- Effect size16.6%; AOR = 1.31; AOR = 1.35
- Evidence strengthModerate
How this study scored 53/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 31 of the 58 points we could judge it on, which is 53 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,699 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 25369872) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 31 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 31 of the 58 points we could judge it on is 53 out of 100. |
| Total | 53 / 100 | — |
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