Statin treatment and mortality in community-dwelling frail older patients with diabetes mellitus: A retrospective observational study

Alberto Pilotto, Francesco Panza, Massimiliano Copetti, Matteo Simonato, Daniele Sancarlo, Pietro Gallina, Timo Strandberg, Alfonso Cruz-Jentoft, Julia Daragjati, Luigi Ferrucci, Andrea Fontana, Stefania Maggi, Francesco Mattace-Raso, Marc Paccalin, Maria Cristina Polidori, Ralf Joachim Schulz, Eva Topinkova, Gianluca Trifirò, Anna Karin Welmer

Research output: Contribution to journalArticle

Abstract

Background: Older adults are often excluded from clinical trials. Decision making for administration of statins to older patients with diabetes mellitus (DM) is under debate, particularly in frail older patients with comorbidity and high mortality risk. We tested the hypothesis that statin treatment in older patients with DM was differentially effective across strata of mortality risk assessed by the Multidimensional Prognostic Index (MPI), based on information collected with the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA). Methods: In this retrospective observational study, we estimated the mortality risk in 1712 community-dwelling subjects with DM ≥ 65 years who underwent a SVaMA evaluation to establish accessibility to homecare services/nursing home admission from 2005 to 2013 in the Padova Health District, Italy. Mild (MPI-SVaMA-1), moderate (MPI-SVaMA-2), and high (MPI-SVaMA-3) risk of mortality at baseline and propensity score-adjusted hazard ratios (HR) of three-year mortality were calculated according to statin treatment. Results: Higher MPI-SVaMA scores were associated with lower rates of statin treatment (MPI-SVaMA-1 = 39% vs MPI-SVaMA-2 = 36% vs MPI-SVaMA-3 = 24.9%. p

Original languageEnglish (US)
Article numbere0130946
JournalPLoS One
Volume10
Issue number6
DOIs
StatePublished - Jun 25 2015
Externally publishedYes

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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    Pilotto, A., Panza, F., Copetti, M., Simonato, M., Sancarlo, D., Gallina, P., Strandberg, T., Cruz-Jentoft, A., Daragjati, J., Ferrucci, L., Fontana, A., Maggi, S., Mattace-Raso, F., Paccalin, M., Polidori, M. C., Schulz, R. J., Topinkova, E., Trifirò, G., & Welmer, A. K. (2015). Statin treatment and mortality in community-dwelling frail older patients with diabetes mellitus: A retrospective observational study. PLoS One, 10(6), [e0130946]. https://doi.org/10.1371/journal.pone.0130946