cardiovascular-agents and Dementia

Elderly subjects with cognitive disorders are at particularly high risk of adverse drug reactions (ADRs). The objectives of our systematic review were to describe the prevalence of ADRs in elderly patients with cognitive disorders, the different types of ADRs and the medications suspected of involvement; to describe whether the ADRs were preventable or not, and to identify risk factors for occurrence of ADRs in this population. A bibliographic search was performed in the following databases: PubMed, Embase, Google Scholar, Opengrey and Scopus. The search included all publications up to and including 4th February 2015, with no specific start date specified. Studies concerning ADRs in elderly patients with cognitive disorders or dementia were included. Two senior authors identified eligible studies and extracted data independently. In total, 113 studies were identified by the bibliographic search, of which six full-text articles were retained and analyzed. Prevalence of ADRs ranged from 4.8 to 37%. The main ADRs reported were neurological and psychological disorders, gastro-intestinal disorders, dermatological and allergic disorders, falls, renal and urinary disorders, cardiovascular disorders, metabolic disorders and electrolyte imbalance, and hemorrhagic events. The medications most commonly suspected of involvement in the ADRs were drugs affecting the nervous system, cardiovascular drugs, anticoagulants, and painkillers. Medical prescriptions should take into account the presence of Alzheimer's disease and related syndromes. Compliance should systematically be evaluated, and cognitive disorders need to be better recognized. Therapeutic education of patients and/or their caregiver is key to management of elderly patients with cognitive disorders.

Topics: Aged; Analgesics; Anticoagulants; Cardiovascular Agents; Cognition Disorders; Dementia; Drug-Related Side Effects and Adverse Reactions; Humans; Prevalence; Risk Factors

Salvia miltiorrhiza (danshen) is widely used for the clinical treatment of cerebral ischemia and cardiovascular diseases. Its diverse molecular makeup of simple and poly hydroxycinnamic acids and diterpenoid quinones are also associated with its beneficial health effects such as improved cognitive deficits in mice, protection of neuronal cells, prevention of amyloid fibril formation and preformed amyloid fibril disaggregation related to Alzheimer's disease. Whilst the in vitro studies have therapeutic promise, the anti-dementia effect/impact of danshen however depends on its absorbed constituents and pharmacokinetic properties. Both the water and lipid danshen fractions have been shown to have low oral bioavailability and at physiological pH, the polyphenolic carboxylate anions are not brain permeable. To tap into the many neuroprotective and other biological benefits of danshen, the key challenge resides in developing danshen nanopharmaceuticals, semi-synthetic pro-drug forms of its constituents to improve its biocompatability, that is, absorption, circulation in bloodstream and optimization of BBB permeability.

Topics: Animals; Antioxidants; Cardiovascular Agents; Dementia; Drugs, Chinese Herbal; Humans; Phenanthrolines; Prodrugs; Salvia miltiorrhiza

The prevalence of vascular cognitive impairment (VCI) is likely to increase as the population ages and cardiovascular disease survival improves. We provide an overview of the definition and disease mechanisms of VCI and present a systematic literature review of the current evidence for the pharmacologic and nonpharmacologic therapies used to treat the VCI symptoms of cognitive dysfunction or to modify VCI through primary and secondary prevention. The Cochrane Database of Systematic Reviews was searched from 2005 to October 2010 using the keywords "vascular dementia" or "vascular cognitive impairment and therapy." MEDLINE was searched for English-language articles published within the last 10 years using the combined Medical Subject Headings (MeSH) "therapeutics and dementia," "vascular" or "vascular cognitive impairment." Although cholinesterase inhibitors and memantine produce small cognitive improvements in patients with VCI, these drugs do not improve global clinical outcomes and have adverse effects and costs. Selective serotonin reuptake inhibitors and dihydropyridine calcium channel blockers may improve short-term cognitive function in patients with VCI. Anti-hypertensive therapy with an ACE inhibitor-based regimen and statins may prevent the major subtype of VCI known as poststroke cognitive decline. Clinical and effectiveness studies with long-term follow-up are needed to determine the benefits and risks of pharmacologic and nonpharmacologic therapies to prevent and treat VCI. Given its growing health, social, and economic burden, the prevention and treatment of VCI are critical priorities for clinical care and research.

Topics: Cardiovascular Agents; Cholinesterase Inhibitors; Cognition Disorders; Cognitive Behavioral Therapy; Dementia; Excitatory Amino Acid Antagonists; Humans; MEDLINE; Randomized Controlled Trials as Topic; Risk Factors; Vascular Diseases; Vitamins

The Ginkgo biloba extract EGb 761 interferes with pathomechanisms relevant to dementia, such as Abeta aggregation, mitochondrial dysfunction, insulin resistance, and hypoperfusion. The efficacy of EGb 761 in the treatment of dementia (Alzheimer's disease and vascular dementia) has been studied in 10 randomised, controlled, double-blind clinical trials. In three of the four large trials conducted in accordance with recent recommendations EGb 761 was significantly superior to placebo with respect to cognitive performance and one or more further (global, functional or behavioural) outcomes demonstrating the clinical relevance of the findings. The findings from the six smaller trials are in line with those of the large trials. One trial was inconclusive, but of questionable external validity due to uncommonly rigorous patient selection. Subgroup analyses of this study together with the findings from the most recent clinical trial suggest that EGb 761 may be most beneficial to patients with neuropsychiatric symptoms, who actually constitute the majority of dementia patients. Delay in symptom progression, rates of clinically significant treatment response and numbers needed to treat (NNT) found for EGb 761 are in the same range as those reported for cholinesterase inhibitors. In an exploratory trial comparing EGb 761 and donepezil, no statistically significant or clinically relevant differences were seen. Hence, EGb 761 has its place in the treatment of dementia.

Topics: Aged; Cardiovascular Agents; Dementia; Ginkgo biloba; Humans; Plant Extracts; Randomized Controlled Trials as Topic; Treatment Outcome

Topics: Aged; Alzheimer Disease; Cardiovascular Agents; Dementia; Ginkgo biloba; Humans; Neuropsychological Tests; Plant Extracts; Randomized Controlled Trials as Topic

The issue of drug-drug interactions is particularly relevant for geriatric patients with epilepsy because they are often treated with multiple medications for concurrent diseases such as cardiovascular disease and psychiatric disorders (e.g., dementia and depression). The antidepressants with the least potential for altering antiepileptic drug (AED) metabolism are citalopram, escitalopram, venlafaxine, duloxetine, and mirtazapine. The use of established AEDs with enzyme-inducing properties, such as carbamazepine, phenytoin, and phenobarbital, may be associated with reductions in the levels of drugs such as donepezil, galantamine, and particularly warfarin. Carbamazepine, phenytoin, and phenobarbital have been reported to decrease prothrombin time in patients taking oral anticoagulants, although with phenytoin, an increase in prothrombin time has also been reported. Drugs associated with increased risk of bleeding in patients taking oral anticoagulants include selective serotonin reuptake inhibitors (especially fluoxetine), gemfibrozil, fluvastatin, and lovastatin. Other drugs affected by enzyme inducers include cytochrome P450 3A4 substrates, such as calcium channel blockers (e.g., nimodipine, nilvadipine, nisoldipine, and felodipine) and the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors atorvastatin, lovastatin, and simvastatin. Although there have been no reports of AEDs altering ticlopidine metabolism, ticlopidine coadministration can result in carbamazepine and phenytoin toxicity. Also, there is a significant risk of elevated levels of carbamazepine when diltiazem and verapamil are administered. In addition, there are case reports of phenytoin toxicity when administered with diltiazem. Drugs with a lower potential for metabolic drug interactions include (1) cholinesterase inhibitors (although the theoretical possibility of a reduction in donepezil and galantamine levels by enzyme-inducing AEDs should be considered) and the N-methyl-D-aspartate receptor antagonist memantine and (2) antihypertensives such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, hydrophilic beta-blockers, and thiazide diuretics. There is a moderate risk that enzyme-inducing AEDs will decrease levels of lipophilic beta-blockers. Newer AEDs have a lower potential for drug interactions. In particular, levetiracetam and gabapentin have not been reported to alter enzyme activity. In summary, there is a significant potential for drug i

Topics: Aged; Aging; Anticonvulsants; Antidepressive Agents; Antipsychotic Agents; Cardiovascular Agents; Dementia; Drug Interactions; Humans; Risk Assessment

To examine the appropriateness of cardiovascular (CV) medication prescribing of patients admitted to a geriatric psychiatry ward. Secondary aims included examining: 1) if differences in CV medication prescribing existed between admission and discharge and 2) if differences in CV medication prescribing existed between patients with and without dementia.. Cross-sectional study.. Inpatient geriatric psychiatry unit within a regional medical center.. 197 patients admitted between June 2005 and May 2006.. Changes in CV medication prescribing from admission to discharge.. On admission, the percent of patients receiving appropriate CV medications for general CV prevention, atrial fibrillation, coronary-artery disease, and heart failure ranged from 33% to 56%. With the exception of the treatment of heart failure, no significant improvements in appropriate CV medication prescribing were noted at the time of discharge. No differences in CV medication prescribing were found between patients with and without dementia.. Despite the known benefits of numerous CV medications in older adults, many patients admitted to a geriatric psychiatry ward were not prescribed optimal pharmacotherapeutic regimens on admission or had their medications changed by the time of discharge.

Topics: Aged; Cardiovascular Agents; Cardiovascular Diseases; Cross-Sectional Studies; Dementia; Drug Monitoring; Drug Utilization; Female; Humans; Male; North Carolina; Patient Admission; Patient Discharge; Practice Patterns, Physicians'; Psychiatric Department, Hospital

In a randomised, double-blind, 22-week trial 400 patients with dementia associated with neuropsychiatric features were treated with Ginkgo biloba extract EGb 761 (240 mg/day) or placebo. Patients with probable Alzheimer's disease, possible Alzheimer's disease with cerebrovascular disease or vascular dementia were eligible if they scored 9 to 23 on the SKT cognitive test battery and at least 5 on the Neuropsychiatric Inventory (NPI). EGb 761 was significantly superior to placebo with respect to the primary (SKT test battery) and all secondary outcome variables. The mean composite score (frequency x severity) and the mean caregiver distress score of the NPI dropped from 21.3 to 14.7 and 13.5 to 8.7, respectively, in the EGb 761-treated patients, but increased from 21.6 to 24.1 and 13.4 to 13.9, respectively, under placebo (p < 0.001). The largest drug-placebo differences in favour of EGb 761 were found for apathy/indifference, anxiety, irritability/lability, depression/dysphoria and sleep/nighttime behaviour.

Topics: Aged; Alzheimer Disease; Cardiovascular Agents; Dementia; Dementia, Vascular; Double-Blind Method; Geriatric Assessment; Ginkgo biloba; Humans; Middle Aged; Neuropsychological Tests; Phytotherapy; Plant Extracts; Time Factors; Treatment Outcome

Patients with atrial fibrillation (AF) have an increased dementia risk dementia. We aimed to study the effect of antihypertensive drugs on dementia in AF patients.. Included patients were ≥45 years diagnosed with AF in Swedish National Patient Register (n=160,251; 89,723 men and 70,528 women) and alive on January 1, 2007. We excluded patients with dementia before onset of AF. Cox regression was used (hazard ratios, HRs, and 99% confidence interval, CI) with adjustments for sex, age, socioeconomic factors and co-morbidities, using incident dementia diagnosis until December 31, 2015 as outcome. Cardiovascular pharmacotherapies were obtained from the Swedish Prescribed Drug Register.. Incident dementia occurred in 9532 patients (5.9%), 4669 men (5.2%) and 4863 women (6.9%). ARBs were associated with lower risk for all patients (HR 0.87, 99% CI 0.78-0.98), especially in the ages 65-84 years of age (HR 0.87, 99% CI 0.76-0.99). Loop-diuretics were associated with higher risk for all dementia among patients 65-84 years of age (HR 1.16, 99% CI 1.00-1.35), and in the sub-group of other causes of dementia than Alzheimer Disease (AD) and vascular dementia (VaD) (HR 1.14, 99% CI 1.00-1.30), but with a lower risk in the sub-group of AD and VaD (HR 0.81, 99% CI 0.68-0.95).. ARBs were associated with a decreased incidence of dementia, and loop diuretics with a higher risk in general but lower risk in the AD and VaD sub-group. ARBs could have specific advantages in prevention of dementia, but the results need confirmation in further studies.

Topics: Age Factors; Aged; Aged, 80 and over; Atrial Fibrillation; Cardiovascular Agents; Cohort Studies; Dementia; Female; Humans; Incidence; Male; Middle Aged; Sweden

Atrial fibrillation (AF) and dementia are predominant among the elderly; patients with AF have an increased dementia risk. We aimed to study if prescribed antihypertensive drugs and cardiovascular pharmacotherapies are associated with a lower relative risk of dementia.. All included patients were ≥45 years and diagnosed with AF in primary care; 12,096 (6580 men and 5516 women) in Sweden. We excluded patients with a dementia diagnosis before onset of AF. Cox regression was used (hazard ratios, HRs, and 95% confidence interval, CI) with adjustments for sex, age, socioeconomic factors and co-morbidities.. Incident dementia occurred in 750 patients (6.2%) during an average of 5.6 years of follow-up (a total of 69,214 person-years). Patients prescribed thiazides HR 0.81 (95% CI 0.66-0.99) and warfarin HR 0.78 (95% CI 0.66-0.92) had a lower risk of dementia than patients without these drugs. The use of 1-4 of the different antihypertensive drug classes (thiazides, beta blocker, vessel active calcium channel blockers or renin angiotensin aldosterone (RAAS) blockers) were associated with a reduction of incident dementia; HR 0.80 (95% CI 0.64-1.00) for one to two drugs, and HR 0.63 (95% CI 0.46-0.84) for three or four drugs, versus having no prescribed antihypertensive drugs. The combination of a RAAS-blocker and a thiazide was significant, HR 0.70 (95% CI 0.53-0.92), versus not having that particular combination prescribed, while RAAS-blockers or thiazides separately were not significant.. Prescribed antihypertensive drugs, including thiazide/RAAS-blocker combination therapy and use of warfarin, were associated with a decreased incidence of dementia.

Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Atrial Fibrillation; Cardiovascular Agents; Dementia; Female; Follow-Up Studies; Humans; Hypertension; Incidence; Male; Middle Aged; Risk Factors; Sweden; Thiazides; Warfarin

To assess changes in medication use after a diagnosis of dementia in individuals with type 2 diabetes mellitus.. Difference-in-differences analysis of changes in the number of dispensed chronic medications between individuals with and without newly diagnosed dementia.. Integrated healthcare delivery system, Kaiser Permanente Northern California.. Individuals aged 50 and older without prevalent dementia with type 2 diabetes mellitus enrolled in a baseline survey. During 5 years of follow-up, 193 individuals with a new diagnosis of dementia were identified, and risk-set sampling was used to randomly select five reference subjects per case matched on 5-year age categories and sex (965 matched participants), resulting in an analytical sample of 1,158.. The exposure was new diagnosis of dementia. The primary outcome was change in number of current chronic medications (total, cardiovascular (blood pressure and lipid control), diabetes mellitus) at three times: 1 year before index date (preindex date), date of diagnosis of dementia or matched reference date (index date), and up to 1 year after index date or end of follow-up if censored before 1 year (postindex date).. After adjustment, the number of chronic medications and the subset of cardiovascular medications declined after a dementia diagnosis in the overall cohort and in age-, sex-, and time-matched reference individuals, but the decline was significantly greater in the group with dementia (0.71 medications fewer than the reference group, P = .02). The number of diabetes mellitus medications declined in both groups, but the declines were not statistically different (0.18 medications fewer than the reference group, P = .008).. Use of cardiometabolic medications fell after a diagnosis of dementia, as recommended in national guidelines.

Topics: Aged; Aged, 80 and over; California; Cardiovascular Agents; Cohort Studies; Dementia; Diabetes Mellitus, Type 2; Drug Utilization; Female; Follow-Up Studies; Humans; Hypoglycemic Agents; Male; Middle Aged; Polypharmacy

Dementia is a chronic disease associated with numerous cardiovascular disorders.. To analyze the prevalence of cardiovascular drug use in dementia patients treated in general practices in Germany.. The present study included patients who were diagnosed with dementia (Alzheimer's disease, vascular dementia, or unspecified dementia) in 2015. The main outcome measure was the proportion of patients using cardiovascular drugs. Demographical and clinical variables included age, sex, dementia type, and cardiovascular co-diagnoses. A multivariate logistic regression model was used to analyze the association between cardiovascular drug use and these variables.. We identified 7,987 and 1,268 dementia patients with and without prescriptions for cardiovascular drugs, respectively. The share of individuals who received cardiovascular treatments was 86.3%. Diuretics (20.9%), beta blocking agents (20.0%), and ACE inhibitors (17.4%) were the three most commonly prescribed types of medications. Patients between the ages of 71-80 (OR = 1.59), 81-90 (OR = 1.61), and over 90 years (OR = 1.48) were more likely to receive cardiovascular drugs than patients under the age of 70 years. Moreover, compared to those with unspecified dementia, individuals with Alzheimer's disease had a lower chance while those with vascular dementia had a higher chance of being prescribed these drugs (ORs equal to 0.81 and 1.22, respectively). Finally, we found a positive association between the use of cardiovascular drugs and all co-diagnoses (ORs ranging from 1.23 to 7.12).. The prevalence of cardiovascular drug use in dementia patients was around 86%. This use was significantly associated with such factors as age, type of dementia, and co-diagnoses.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Cardiovascular Agents; Comorbidity; Dementia; Female; General Practice; Germany; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prevalence; Retrospective Studies

it is unknown whether the age-specific prevalence of dementia among the very old changes over time.. this study compares the prevalence of dementia in two population-based cross-sectional samples of very old people in northern Sweden in 2000-02 and in 2005-07. In total, 430 individuals aged 85 and older (mean age 89.5 years, 71.4% women) were evaluated for dementia in the first cross-section and 465 individuals (mean age 90.2 years, 70.9% women) in the second. Trained assessors performed assessments and interviews during home visits and collected information from carers, relatives and medical records. Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria.. the prevalence of dementia in the total sample was 26.5% in 2000-02 and 37.2% in 2005-07 (P = 0.001). There was also an increase in the prescription of different antihypertensive agents, antilipemic agents and choline esterase inhibitors, and more people had had heart surgery in the later sample.. in this sample of very old people, an increase in the age-specific prevalence of dementia was detected over 5 years. Possible reasons for this may be extended survival among individuals with risk factors for dementia and among individuals with established dementia.

Topics: Aged, 80 and over; Cardiovascular Agents; Chi-Square Distribution; Cholinesterase Inhibitors; Cognition; Cross-Sectional Studies; Dementia; Female; Geriatric Assessment; Humans; Logistic Models; Male; Odds Ratio; Prevalence; Psychiatric Status Rating Scales; Risk Factors; Surveys and Questionnaires; Sweden; Time Factors

The aim of this study was to investigate drug treatment patterns for heart failure (HF) in the very elderly and, in particular, to determine if angiotensin-converting enzyme inhibitors (ACEIs) were under-used by demented persons.. The 265 participants investigated in this study were all 75 years and older, with HF and using cardiovascular drugs, and were part of the Nordanstig cohort (919 persons) of the population-based Kungsholmen project. Data on demographics, medical conditions, including dementia and HF from the baseline investigation 1995-1998, and drug use data from the baseline and follow-up (1999-2001) investigations were used.. ACEIs were used by 25.7% of the participants. After adjustment for sociodemographic and medical background factors, there was no significant difference in ACEI use by dementia status, but use was lower with increasing age: the odds ratio (OR) was 0.11 and the 95% confidence interval (95%CI) was 0.01-0.95 between participants 90 years and older and those 75-79 years old (p=0.045). Use was also lower in those persons living in an institution compared to community-living elderly (OR: 0.28; 95% CI: 0.09-0.91; p=0.034). Only 15.8% of the participants used beta-blockers. Of the 12.8% using calcium channel blockers, 82% used preparations with negative inotropic effects. Non-steroid antiinflammatory drugs (NSAIDS), contraindicated in HF, were used by 10.6%.. No significant difference in ACEI utilization related to dementia diagnosis was shown, but the study did reveal a significantly lower use in the oldest age group and in elderly persons living in institutions. The low utilization rates of ACEIs and beta-blockers, the high proportion of calcium channel blockers with negative inotropic effects, and the fairly frequent use of NSAIDs in the study cohort suggest that the quality in drug treatment of very old people with HF can be improved.

Topics: Aged; Aged, 80 and over; Angiotensin-Converting Enzyme Inhibitors; Cardiovascular Agents; Dementia; Demography; Female; Heart Failure; Humans; Male; Odds Ratio; Prevalence; Time Factors

To compare medication use in patients suffering from cardiovascular disease with and without dementia.. All inhabitants aged 75 and older in Lieto, Finland (n = 462, participation rate 82%).. Direct standardised assessments of dementia and cardiovascular diseases. Quantification of drug use by self-report and by prescription and drug container checks.. In multivariate analyses, the odds ratio for demented cardiovascular patients receiving any cardiovascular medication (use vs. non-use) was 0.31 (95% confidence interval 0.12-0.82). Compared to the non-demented, demented stroke patients were treated less often with antithrombotic agents (p = 0.041) and demented hypertensive patients less often with beta-blockers (p = 0.045).. Demented cardiovascular patients, even mildly to moderately demented, were prescribed fewer evidence-based cardiovascular medications than non-demented patients.

Topics: Aged; Cardiovascular Agents; Cardiovascular Diseases; Dementia; Electrocardiography; Female; Finland; Humans; Longitudinal Studies; Male; Neuropsychological Tests; Patient Compliance; Population; Risk Assessment

To determine differences in mortality after admission for acute myocardial infarction (AMI) and in use of noninvasive and invasive treatments for AMI between patients with and without dementia.. Retrospective chart review.. Cooperative Cardiovascular Project.. Medicare patients admitted for AMI (N=129,092) in 1994 and 1995.. Dementia noted on medical chart as history of dementia, Alzheimer's disease, chronic confusion, or senility. Outcome measures included mortality at 30 days and 1-year postadmission; use of aspirin, beta-blocker, angiotensin-converting enzyme (ACE) inhibitor, thrombolytic therapy, cardiac catheterization, coronary angioplasty, and cardiac bypass surgery compared by dementia status.. Dementia was associated with higher mortality at 30 days (relative risk (RR)=1.16, 95% confidence interval (CI)=1.09-1.22) and at 1-year postadmission (RR=1.18, 95% CI=1.13-1.23). There were few to no differences in the use of aspirin and beta-blockers between patients with and without a history of dementia. Patients with a history of dementia were less likely to receive ACE inhibitors during the stay (RR=0.89, 95% CI=0.86-0.93) or at discharge (RR=0.90, 95% CI=0.86-0.95), thrombolytic therapy (RR=0.82, 95% CI=0.74-0.90), catheterization (RR=0.51, 95% CI=0.47-0.55), coronary angioplasty (RR=0.58, 95% CI=0.51-0.66), and cardiac bypass surgery (RR=0.41, 95% CI=0.33-0.50) than patients without a history of dementia.. The results imply that the presence of dementia had a major effect on mortality and care patterns for this condition.

Topics: Aged; Aged, 80 and over; Cardiac Catheterization; Cardiovascular Agents; Decision Making; Dementia; Female; Humans; Logistic Models; Male; Medical Audit; Medicare; Multivariate Analysis; Myocardial Infarction; Myocardial Revascularization; Outcome and Process Assessment, Health Care; Retrospective Studies; Socioeconomic Factors; United States

Atrial fibrillation is a frequent disorder in the elderly and a known risk factor for cerebrovascular stroke. We investigated the association of atrial fibrillation with dementia and cognitive impairment in a large cross-sectional, population-based study in the elderly.. Of the 6584 participants in the Rotterdam Study aged 55 to 106 years, detailed information on dementia status and ECG abnormalities was available. Dementia was diagnosed in three phases. First, participants were screened. Screen-positive subjects were tested further. Those with possible dementia underwent an extensive diagnostic workup. Dementia and dementia subtypes were diagnosed according to prevailing criteria. Cognitive impairment was defined as a Mini-Mental State Examination test score of < 26 points for a nondemented subject.. Atrial fibrillation was diagnosed in 195, dementia in 276, and cognitive impairment in 635 subjects. We found significant positive associations of atrial fibrillation with both dementia and impaired cognitive function (age- and sex-adjusted odds ratios, 2.3 [95% confidence interval, 1.4 to 3.7] and 1.7 [95% confidence interval, 1.2 to 2.5]), respectively). The strongest association was found not for vascular dementia but rather for Alzheimer's disease with cerebrovascular disease. The associations were stronger in women, and the relation with dementia was more pronounced in the relatively younger elderly. A history of stroke in subjects with atrial fibrillation could not account for these associations.. Dementia and subtypes Alzheimer's disease and vascular dementia may be related to atrial fibrillation even if no clinical stokes have occurred.

Topics: Age Factors; Aged; Aged, 80 and over; Anti-Arrhythmia Agents; Atrial Fibrillation; Cardiac Output, Low; Cardiovascular Agents; Cerebrovascular Circulation; Cognition Disorders; Comorbidity; Cross-Sectional Studies; Dementia; Dementia, Vascular; Electrocardiography; Female; Humans; Male; Middle Aged; Netherlands; Prevalence; Risk Factors

The purpose of this study was to identify the prevalence and predictors of commonly prescribed regularly scheduled medications.. Data were collected on the first day following nursing home admission in this non-experimental study.. A stratified, proportional probability sample of eight nursing homes in a large Mid-South city participated in this study.. A consecutive sample of 574 new and readmitted nursing home residents who did not refuse participation.. None.. Data were collected on regularly scheduled prescription medications and resident and nursing home characteristics.. Residents without a diagnosis of dementia were more likely to receive cardiovascular medications (Odds Ratio = 2.34; 95% CI = 1.56-3.49), and white residents were more likely to receive cardiovascular medications (Odds Ratio = 1.74; 95% CI = 1.19-2.53) or central nervous system medications (Odds Ratio = 1.72; 95% CI = 1.18-2.51). Older residents were less likely to receive central nervous system medications (Odds Ratio = 0.97 per year; 95% CI = 0.96-0.99), and females were more likely to receive cardiovascular medications (Odds Ratio = 1.89; 95% CI = 1.30-2.75).. Resident characteristics were the most important predictors for cardiovascular and central nervous system medication prescriptions of new and readmitted nursing home residents.

Topics: Adult; Aged; Aged, 80 and over; Black or African American; Cardiovascular Agents; Cardiovascular Diseases; Central Nervous System Agents; Comorbidity; Dementia; Drug Prescriptions; Female; Humans; Male; Middle Aged; Nursing Homes; Patient Admission; Predictive Value of Tests; Prevalence; Sampling Studies; Sex Factors; Southeastern United States; Southwestern United States; White People