Evidence map›Paper›PMID 24454696›Full record

ArticlePloS one2014

Impact of high risk drug use on hospitalization and mortality in older people with and without Alzheimer's disease: a national population cohort study.

Danijela Gnjidic, Sarah N Hilmer, Sirpa Hartikainen, Anna-Maija Tolppanen, Heidi Taipale, Marjaana Koponen, J Simon Bell

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 4 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 4 syntheses or guidelines pooled it, 104 citations in OpenAlex.

  1. Pooled it
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  6. Article
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  9. Observational
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  12. Observational
  13. Article
  14. Medication misuse and overuse in community-dwelling persons with dementia.Journal of the American Geriatrics Society · 2023
    Article
  15. Article
  16. Anticholinergic action is rarely a good thing.Therapeutic advances in psychopharmacology · 2023
    Review
  17. Polypharmacy in Older Adults with Alzheimer's Disease.Medicina (Kaunas, Lithuania) · 2022
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Danijela GnjidicFaculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia ; Departments of Clinical Pharmacology and Aged Care, and Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, New South Wales, Australia ; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia ; Centre for Education and Research on Ageing and Concord RG Hospital, Sydney, New South Wales, Australia.
Sarah N HilmerDepartments of Clinical Pharmacology and Aged Care, and Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, New South Wales, Australia ; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Sirpa HartikainenKuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Anna-Maija TolppanenDepartment of Neurology, University of Eastern Finland, Kuopio, Finland.
Heidi TaipaleKuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Marjaana KoponenKuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
J Simon BellKuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland ; Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia ; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
University of Eastern Finland · FIConcord Repatriation General Hospital · AUMonash University · AUUniversity of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvidence is lacking about outcomes associated with the cumulative use of anticholinergic and sedative drugs in people with Alzheimer's disease (AD). This retrospective cohort study investigated the relationship between cumulative exposure to anticholinergic and sedative drugs and hospitalization and mortality in people with and without AD in Finland.

methodsCommunity-dwelling people aged 65 years and over, with AD on December 31(st) 2005 (n = 16,603) and individually matched (n = 16,603) comparison persons (age, sex, region of residence) were identified by the Social Insurance Institution of Finland. Drug utilization data were extracted from the Finnish National Prescription Register. Exposure to anticholinergic and sedative drugs was defined using the Drug Burden Index (DBI). Hospitalization and mortality data were extracted from national registers. Cox and zero-inflated negative binomial analyses were used to investigate the relationship between DBI and hospitalization and mortality over a one-year follow-up.

resultsIn total, 5.8% of people with AD and 3.7% without AD died during 2006. For every unit increase in DBI, the adjusted hazard ratio for mortality was 1.21 (95% confidence intervals [CI]: 1.09-1.33) among people with AD, and 1.37 (95%CI: 1.20-1.56) among people without AD. Overall, 44.3% of people with AD and 33.4% without AD were hospitalized. When using no DBI exposure as the reference group, the adjusted incidence rate ratio for length of hospital stay among high DBI group (≥1) in people with AD was 1.15 (95%CI: 1.05-1.26) and 1.63 (95%CI: 1.41-1.88) in people without AD.

conclusionThere is a dose-response relationship between cumulative anticholinergic and sedative drug use and hospitalization and mortality in people with and without AD.

Indexed as

AgedAged, 80 and overAlzheimer DiseaseCholinergic AntagonistsCohort StudiesFemaleFinlandHospitalizationHumansHypnotics and SedativesLength of StayMalePrescription Drug MisuseRegression AnalysisRisk FactorsCholinergic AntagonistsHypnotics and Sedatives

Identifiers

PMID24454696
PMCPMC3890276
OpenAlexW2114539601

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.