Older Adults With Dementia More Likely to Receive Pacemaker
(HealthDay News) — Older adults with dementia are more likely to receive a pacemaker than those without cognitive impairment, according to a research letter published online July 28 in JAMA Internal Medicine.
Nicole R. Fowler, PhD, MHSA, from the University of Pittsburgh, and colleagues conducted a retrospective cohort study using data from 33 Alzheimer's disease centers to describe the epidemiology of cardiac implantable electronic devices among a population-based sample of older adults with and without cognitive impairment. The cohort included 16,245 participants with a baseline visit and at least one follow-up visit from September 2005 through December 2011.
The researchers found that over the seven-year study period the rates of incident pacemakers were 4, 4.7, and 6.5 per 1,000 person-years for participants with no cognitive impairment, mild cognitive impairment, and dementia, respectively (P=0.001). After adjustment, the likelihood of receiving a pacemaker was increased 1.6-fold for participants with incident dementia at the visit before assessment for incident pacemaker, compared to those without cognitive impairment (P=0.02). Compared with those without cognitive impairment, participants with stable dementia were 1.8-fold more likely to receive a pacemaker in a model that accounted for cognitive status over consecutive visits. Participants with severe dementia (clinical dementia rating, 3) were 2.9-fold more likely to receive a pacemaker than those with no cognitive impairment in a model for severity of cognitive impairment (P=0.02).
"Patients with dementia were more likely to receive a pacemaker than patients without cognitive impairment, even after adjusting for clinical risk factors," the authors write.