TY - JOUR
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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U2 - 10.1371/journal.pone.0130946
DO - 10.1371/journal.pone.0130946
M3 - Article
C2 - 26110884
AN - SCOPUS:84938340869
VL - 10
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 6
M1 - e0130946
ER -