Age, dementia and care patterns after admission for acute coronary syndrome: an analysis from a nationwide cohort under the National Health Insurance coverage.

Chen Fang Lin, Fe Lin Lin Wu, Shu Wen Lin, Chyi Huey Bai, Ding Cheng Chan, Churn Shiouh Gau, Fei Yuan Hsiao, Li Jiuan Shen

研究成果: 雜誌貢獻文章

14 引文 (Scopus)

摘要

The number of elderly and the prevalence of dementia have grown considerably in recent years. Little is known about how aging and dementia affect care patterns after discharge for acute coronary syndrome (ACS). This study was designed to assess the impact of dementia on care patterns after admission for patients with ACS across different age groups. Of 87,321 patients hospitalized for ACS between 1 January 2006 and 31 December 2007, 1,835 patients with dementia and 3,670 matched patients without dementia (1:2 ratio, matched by age, sex and hospital level) were identified from Taiwan's National Health Insurance Research Database. Use of interventional therapies at hospitalization and guideline-recommended medications post-discharge were compared between patients with and without dementia across different age groups (≤65, 66-75, 76-85, ≥86 years). Multivariate logistic regression models were performed to examine the impact of dementia on care patterns. Overall, dementia was associated with a 27% lower likelihood of receipt of interventional therapies [adjusted odds ratio (OR) = 0.73; 95% CI 0.63, 0.83] and a 22% lower likelihood of guideline-recommended medications (adjusted OR = 0.78; 95% CI 0.68, 0.89) in ACS patients. The use of interventional therapies and guideline-recommended medications decreased with age, and interactions between age and dementia were found. The proportions of patients receiving interventional therapies were 39.4% (without dementia) versus 21.8% (with dementia) in the youngest age group and 18.6% (without dementia) versus 14.5% (with dementia) in the oldest age group. Patients with dementia (age ≤65 years 73.6%; age 66-75 years 82.3%; age 76-85 years 71.8%; age ≥86 years 55.6%) were less likely to receive guideline-recommended medications as compared with those without dementia (age ≤65 years 85.6%; age 66-75 years 87.5%; age 76-85 years 81.2%; age ≥86 years 62.0%). Dementia and aging were associated with decreased use of interventional therapies and guideline-recommended medications in ACS patients.

原文英語
頁(從 - 到)819-828
頁數10
期刊Drugs and Aging
29
發行號10
出版狀態已發佈 - 十月 2012
對外發佈Yes

指紋

Insurance Coverage
National Health Programs
Acute Coronary Syndrome
Dementia
Guidelines
Age Groups
Logistic Models
Odds Ratio
Therapeutics
Patient Admission
Taiwan

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Geriatrics and Gerontology

引用此文

Age, dementia and care patterns after admission for acute coronary syndrome : an analysis from a nationwide cohort under the National Health Insurance coverage. / Lin, Chen Fang; Wu, Fe Lin Lin; Lin, Shu Wen; Bai, Chyi Huey; Chan, Ding Cheng; Gau, Churn Shiouh; Hsiao, Fei Yuan; Shen, Li Jiuan.

於: Drugs and Aging, 卷 29, 編號 10, 10.2012, p. 819-828.

研究成果: 雜誌貢獻文章

Lin, Chen Fang ; Wu, Fe Lin Lin ; Lin, Shu Wen ; Bai, Chyi Huey ; Chan, Ding Cheng ; Gau, Churn Shiouh ; Hsiao, Fei Yuan ; Shen, Li Jiuan. / Age, dementia and care patterns after admission for acute coronary syndrome : an analysis from a nationwide cohort under the National Health Insurance coverage. 於: Drugs and Aging. 2012 ; 卷 29, 編號 10. 頁 819-828.
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title = "Age, dementia and care patterns after admission for acute coronary syndrome: an analysis from a nationwide cohort under the National Health Insurance coverage.",
abstract = "The number of elderly and the prevalence of dementia have grown considerably in recent years. Little is known about how aging and dementia affect care patterns after discharge for acute coronary syndrome (ACS). This study was designed to assess the impact of dementia on care patterns after admission for patients with ACS across different age groups. Of 87,321 patients hospitalized for ACS between 1 January 2006 and 31 December 2007, 1,835 patients with dementia and 3,670 matched patients without dementia (1:2 ratio, matched by age, sex and hospital level) were identified from Taiwan's National Health Insurance Research Database. Use of interventional therapies at hospitalization and guideline-recommended medications post-discharge were compared between patients with and without dementia across different age groups (≤65, 66-75, 76-85, ≥86 years). Multivariate logistic regression models were performed to examine the impact of dementia on care patterns. Overall, dementia was associated with a 27{\%} lower likelihood of receipt of interventional therapies [adjusted odds ratio (OR) = 0.73; 95{\%} CI 0.63, 0.83] and a 22{\%} lower likelihood of guideline-recommended medications (adjusted OR = 0.78; 95{\%} CI 0.68, 0.89) in ACS patients. The use of interventional therapies and guideline-recommended medications decreased with age, and interactions between age and dementia were found. The proportions of patients receiving interventional therapies were 39.4{\%} (without dementia) versus 21.8{\%} (with dementia) in the youngest age group and 18.6{\%} (without dementia) versus 14.5{\%} (with dementia) in the oldest age group. Patients with dementia (age ≤65 years 73.6{\%}; age 66-75 years 82.3{\%}; age 76-85 years 71.8{\%}; age ≥86 years 55.6{\%}) were less likely to receive guideline-recommended medications as compared with those without dementia (age ≤65 years 85.6{\%}; age 66-75 years 87.5{\%}; age 76-85 years 81.2{\%}; age ≥86 years 62.0{\%}). Dementia and aging were associated with decreased use of interventional therapies and guideline-recommended medications in ACS patients.",
author = "Lin, {Chen Fang} and Wu, {Fe Lin Lin} and Lin, {Shu Wen} and Bai, {Chyi Huey} and Chan, {Ding Cheng} and Gau, {Churn Shiouh} and Hsiao, {Fei Yuan} and Shen, {Li Jiuan}",
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T2 - an analysis from a nationwide cohort under the National Health Insurance coverage.

AU - Lin, Chen Fang

AU - Wu, Fe Lin Lin

AU - Lin, Shu Wen

AU - Bai, Chyi Huey

AU - Chan, Ding Cheng

AU - Gau, Churn Shiouh

AU - Hsiao, Fei Yuan

AU - Shen, Li Jiuan

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N2 - The number of elderly and the prevalence of dementia have grown considerably in recent years. Little is known about how aging and dementia affect care patterns after discharge for acute coronary syndrome (ACS). This study was designed to assess the impact of dementia on care patterns after admission for patients with ACS across different age groups. Of 87,321 patients hospitalized for ACS between 1 January 2006 and 31 December 2007, 1,835 patients with dementia and 3,670 matched patients without dementia (1:2 ratio, matched by age, sex and hospital level) were identified from Taiwan's National Health Insurance Research Database. Use of interventional therapies at hospitalization and guideline-recommended medications post-discharge were compared between patients with and without dementia across different age groups (≤65, 66-75, 76-85, ≥86 years). Multivariate logistic regression models were performed to examine the impact of dementia on care patterns. Overall, dementia was associated with a 27% lower likelihood of receipt of interventional therapies [adjusted odds ratio (OR) = 0.73; 95% CI 0.63, 0.83] and a 22% lower likelihood of guideline-recommended medications (adjusted OR = 0.78; 95% CI 0.68, 0.89) in ACS patients. The use of interventional therapies and guideline-recommended medications decreased with age, and interactions between age and dementia were found. The proportions of patients receiving interventional therapies were 39.4% (without dementia) versus 21.8% (with dementia) in the youngest age group and 18.6% (without dementia) versus 14.5% (with dementia) in the oldest age group. Patients with dementia (age ≤65 years 73.6%; age 66-75 years 82.3%; age 76-85 years 71.8%; age ≥86 years 55.6%) were less likely to receive guideline-recommended medications as compared with those without dementia (age ≤65 years 85.6%; age 66-75 years 87.5%; age 76-85 years 81.2%; age ≥86 years 62.0%). Dementia and aging were associated with decreased use of interventional therapies and guideline-recommended medications in ACS patients.

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