Statin Treatment and Mortality in Community-Dwelling Frail Older Patients with Diabetes Mellitus : A Retrospective Observational Study

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http://hdl.handle.net/10138/160384

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Pilotto , A , Panza , F , Copetti , M , Simonato , M , Sancarlo , D , Gallina , P , Strandberg , T & MPI AGE Project Investigators 2015 , ' Statin Treatment and Mortality in Community-Dwelling Frail Older Patients with Diabetes Mellitus : A Retrospective Observational Study ' PLoS One , vol. 10 , no. 6 , 0130946 . DOI: 10.1371/journal.pone.0130946

Title: Statin Treatment and Mortality in Community-Dwelling Frail Older Patients with Diabetes Mellitus : A Retrospective Observational Study
Author: Pilotto, Alberto; Panza, Francesco; Copetti, Massimiliano; Simonato, Matteo; Sancarlo, Daniele; Gallina, Pietro; Strandberg, Timo; MPI AGE Project Investigators
Contributor: University of Helsinki, Department of Medicine
Date: 2015-06-25
Language: eng
Number of pages: 13
Belongs to series: PLoS One
ISSN: 1932-6203
URI: http://hdl.handle.net/10138/160384
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= 85 years, respectively (interaction test p=0.812). Conclusions Statin treatment was significantly associated with reduced three-year mortality independently of age and multidimensional impairment in community-dwelling frail older patients with DM.
Subject: MULTIDIMENSIONAL PROGNOSTIC INDEX
NURSING-HOME
METAANALYSIS
CHOLESTEROL
WOMEN
RISK
VALIDATION
PREVENTION
GUIDELINES
BENEFITS
3121 Internal medicine
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