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

doi:10.1371/journal.pone.0130946

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

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29 Scopus citations

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 language	English (US)
Article number	e0130946
Journal	PLoS One
Volume	10
Issue number	6
DOIs	https://doi.org/10.1371/journal.pone.0130946
State	Published - Jun 25 2015
Externally published	Yes

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

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, MC, Schulz, RJ, Topinkova, E, Trifirò, G & Welmer, AK 2015, 'Statin treatment and mortality in community-dwelling frail older patients with diabetes mellitus: A retrospective observational study', PLoS One, vol. 10, no. 6, e0130946. https://doi.org/10.1371/journal.pone.0130946

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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",

author = "Alberto Pilotto and Francesco Panza and Massimiliano Copetti and Matteo Simonato and Daniele Sancarlo and Pietro Gallina and Timo Strandberg and Alfonso Cruz-Jentoft and Julia Daragjati and Luigi Ferrucci and Andrea Fontana and Stefania Maggi and Francesco Mattace-Raso and Marc Paccalin and Polidori, {Maria Cristina} and Schulz, {Ralf Joachim} and Eva Topinkova and Gianluca Trifir{\`o} and Welmer, {Anna Karin}",

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T1 - Statin treatment and mortality in community-dwelling frail older patients with diabetes mellitus

T2 - A retrospective observational study

AU - Pilotto, Alberto

AU - Panza, Francesco

AU - Copetti, Massimiliano

AU - Simonato, Matteo

AU - Sancarlo, Daniele

AU - Gallina, Pietro

AU - Strandberg, Timo

AU - Cruz-Jentoft, Alfonso

AU - Daragjati, Julia

AU - Ferrucci, Luigi

AU - Fontana, Andrea

AU - Maggi, Stefania

AU - Mattace-Raso, Francesco

AU - Paccalin, Marc

AU - Polidori, Maria Cristina

AU - Schulz, Ralf Joachim

AU - Topinkova, Eva

AU - Trifirò, Gianluca

AU - Welmer, Anna Karin

PY - 2015/6/25

Y1 - 2015/6/25

N2 - 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

AB - 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

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

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