在有或没有痴呆症的养老院居民中,使用他类药物和全因死亡率:使用索赔数据的回顾性队列研究
Julie Lorraine O'Sullivan1, Raphael Kohl1, Sonia Lech1
1From The Institute for Medical Sociology and Rehabilitation Science (J.L.O.S., R.K., S.L., L.R. J.S. A.K. P.G.), Universitätsmedizin Berlin, corporate member of Freie Universität Berlin; German Center for Mental Health (DZPG) (J.L.O.S., P.G.), partner site Berlin/Potsdam; Department of Psychiatry and Psychotherapy (S.L.) and Friede Springer Cardiovascular Prevention Center (P.G.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; and Divison of Geriatric Medicine and Gerontology (S.Y.), Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.
类固醇药物治疗始终降低了包括痴呆症在内的养老院居民的全因死亡率. 持续服用他类药物可能会降低长期护理痴呆症患者的死亡风险.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
背景情况:
- 在老年痴呆症患者中,他类药物治疗的益处尚未得到充分证实.
- 养老院住户代表一个有复杂健康需求的弱势群体.
研究的目的:
- 评估在有或没有痴呆症的养老院居民中,他类药物使用与全因死亡率之间的关联.
- 为了确定他类药物的益处是否延伸到认知障碍的个体.
主要方法:
- 使用德国医疗保险索赔数据 (2015-2019) 进行的回顾性队列研究.
- 倾向性得分与考克斯的比例危险模型相匹配,分析了他类药物的使用和死亡率.
- 亚组分析包括痴呆类型,动脉样硬化心血管疾病 (ASCVD) 史,他类药物的强度,年龄,性别和护理水平.
主要成果:
- 达丁类药物使用与痴呆症 (HR 0.80) 和非痴呆症 (HR 0.73) 组中所有原因死亡率显著降低有关.
- 在各种子组中,包括有或没有ASCVD病史的人群中,益处是一致的.
- 在患有痴呆症和没有痴呆症的个体之间没有观察到对他类药物的有效性的显著差异.
结论:
- 对于养老院居民来说,无论痴呆症状况如何,他类药物治疗都显示出一致的死亡益处.
- 对于痴呆症的养老院居民,建议继续使用他类药物治疗,以减少全因死亡风险.
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