Association of cardiovascular system medications with cognitive function and dementia in older adults living in nursing homes in Australia

Journal article


Liu, Enwu, Dyer, Suzanne M., O'Donnell, Lisa Kouladjian, Milte, Rachel, Bradley, Clare E., Harrison, Stephanie L., Gnanamanickam, Emmanuel S., Whitehead, Craig and Crotty, Maria. (2017) Association of cardiovascular system medications with cognitive function and dementia in older adults living in nursing homes in Australia. Journal of Geriatric Cardiology. 14(6), pp. 407 - 415. https://doi.org/10.11909/j.issn.1671-5411.2017.06.009
AuthorsLiu, Enwu, Dyer, Suzanne M., O'Donnell, Lisa Kouladjian, Milte, Rachel, Bradley, Clare E., Harrison, Stephanie L., Gnanamanickam, Emmanuel S., Whitehead, Craig and Crotty, Maria
Abstract

OBJECTIVE:
To examine associations between cardiovascular system medication use with cognition function and diagnosis of dementia in older adults living in nursing homes in Australia.
METHODS:
As part of a cross-sectional study of 17 Australian nursing homes examining quality of life and resource use, we examined the association between cognitive impairment and cardiovascular medication use (identified using the Anatomical Therapeutic Classification System) using general linear regression and logistic regression models. People who were receiving end of life care were excluded.
RESULTS:
Participants included 541 residents with a mean age of 85.5 years (± 8.5), a mean Psychogeriatric Assessment Scale-Cognitive Impairment (PAS-Cog) score of 13.3 (± 7.7), a prevalence of cardiovascular diseases of 44% and of hypertension of 47%. Sixty-four percent of participants had been diagnosed with dementia and 72% had received cardiovascular system medications within the previous 12 months. Regression models demonstrated the use of cardiovascular medications was associated with lower (better) PAS-Cog scores [Coefficient (β) = -3.7; 95% CI: -5.2 to -2.2; P < 0.0001] and a lower probability of a dementia diagnosis (OR = 0.44; 95% CI: 0.26 to 0.75, P = 0.0022). Analysis by subgroups of medications showed cardiac therapy medications (C01), beta blocking agents (C07), and renin-angiotensin system agents (C09) were associated with lower PAS-Cog scores (better cognition) and lower dementia diagnosis probability.
CONCLUSIONS:
This analysis has demonstrated an association between greater cardiovascular system medication use and better cognitive status among older adults living in nursing homes. In this population, there may be differential access to health care and treatment of cardiovascular risk factors. This association warrants further investigation in large cohort studies.

KeywordsCardiovascular agents; Cognitive dysfunction; Dementia; Residential facilities
Year2017
JournalJournal of Geriatric Cardiology
Journal citation14 (6), pp. 407 - 415
PublisherChinese P L A General Hospital * Institute of Geriatric Cardiology
ISSN1671-5411
Digital Object Identifier (DOI)https://doi.org/10.11909/j.issn.1671-5411.2017.06.009
Scopus EID2-s2.0-85026292135
Open accessOpen access
Page range407 - 415
Research GroupMary MacKillop Institute for Health Research
Publisher's version
License
Place of publicationChina
EditorsY. Chen
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