Evidence map›Paper›PMID 30764775›Full record

ArticleBMC geriatrics2019

Patterns of antihypertensive and statin adherence prior to dementia: findings from the adult changes in thought study.

Zachary A Marcum, Rod L Walker, Bobby L Jones, Arvind Ramaprasan, Shelly L Gray, Sascha Dublin, Paul K Crane, Eric B Larson

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Medication Adherence Trajectories: A Systematic Literature Review.Journal of managed care & specialty pharmacy · 2020
    Pooled it
  2. Recent topics in hypertensive dementia.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  3. Article
  4. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  5. Hypertensive dementia and blood pressure management from JSH2025.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Statin discontinuation in persons with and without Alzheimer's disease.European journal of clinical pharmacology · 2022
    Article
  11. Article
  12. Predictors of tyrosine kinase inhibitor adherence trajectories in patients with newly diagnosed chronic myeloid leukemia.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2021
    Article
  13. Review
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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

8 authors.

Zachary A MarcumDepartment of Pharmacy, School of Pharmacy, University of Washington, 1959 NE Pacific St, H375G, Box 357630, Seattle, WA, 98195-7630, USA. zmarcum@uw.edu.
Rod L WalkerKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA, 98101, USA.
Bobby L JonesDepartment of Psychiatry, University of Pittsburgh Medical Center, 3811 O'Hara St, Pittsburgh, PA, 15213, USA.
Arvind RamaprasanKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA, 98101, USA.
Shelly L GrayDepartment of Pharmacy, School of Pharmacy, University of Washington, 1959 NE Pacific St, H375G, Box 357630, Seattle, WA, 98195-7630, USA.
Sascha DublinKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA, 98101, USA.
Paul K CraneDivision of General Internal Medicine, School of Medicine, University of Washington, 325 Ninth Avenue, Box 359780, Seattle, WA, 98104, USA.
Eric B LarsonKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA, 98101, USA.

Funding

Furthering scientific understanding of mechanisms underlying resilience to the effects of AD pathology by incorporating state of the art quantification of gliosis, inflammation, & synaptic toxicityU01AG006781 · NIA · UNIVERSITY OF WASHINGTON · PI CRANE, PAUL K, LARSON, ERIC B · 1986 to 2020
$39.3M
UW Patient-Centered Outcomes Research Career Development Program K12 2014 2019K12HS022982 · AHRQ · UNIVERSITY OF WASHINGTON · PI SULLIVAN, SEAN D · 2014 to 2018
$3.8M
AHRQ HHS K12 HS022982NIA NIH HHS U01 AG006781
6 · The paper itself

Abstract

backgroundDetecting patients with undiagnosed dementia is an important clinical challenge. Changes in medication adherence might represent an early sign of cognitive impairment. We sought to examine antihypertensive and statin adherence trajectories in community-dwelling older adults, comparing people who went on to develop dementia to those who did not.

methodsWe analyzed data from Adult Changes in Thought (ACT), a population-based cohort study embedded within an integrated healthcare delivery system. Analyses included 4368 participants aged ≥65 years who had at least one follow-up visit. Research-quality dementia diagnoses were used to identify cases. We selected non-dementia control visits matched on age, sex, and study cohort that occurred at similar ACT follow-up time as the case's dementia onset; we treated this as the index date. Participants were included if they were prevalent users of either a statin or antihypertensive medication on the first day of follow up - 3 years prior to the index date. Using prescription fill dates and days supply, we calculated daily binary medication availability measures for each participant ('days covered') over 3 years leading up to the index date. We used group-based trajectory models to identify patterns of antihypertensive and statin adherence, and used conditional logistic regression to examine associations between adherence trajectories and dementia.

resultsFour trajectories were identified for antihypertensive users (292 cases, 3890 control visits), including near perfect (n = 1877, 36.6% cases, 45.5% controls), high (n = 1840, 43.2% cases, 44.1% controls), moderate (n = 365, 18.5% cases, 8.0% controls) and early poor adherence (n = 100, 1.7% cases, 2.4% controls). Odds of dementia was 3 times greater for those with moderate antihypertensive adherence compared to those with near perfect adherence (adjusted OR 3.0, 95% CI 2.0, 4.3). Four trajectories were identified for statin users (148 cases, 1131 control visits), including high (n = 1004, 75.0% cases, 79.0% controls), moderate (n = 192, 19.6% cases, 14.4% controls), early poor (n = 43, 2.0% cases, 3.5% controls), and delayed poor adherence (n = 40, 3.4% cases, 3.1% controls). No association was detected between statin adherence trajectories and dementia.

conclusionsPatterns of medication adherence may be useful to identify a subset of people at higher likelihood of developing dementia.

Indexed as

AgedAged, 80 and overAntihypertensive AgentsCohort StudiesDementiaFemaleFollow-Up StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLongitudinal StudiesMaleMedication AdherenceProspective StudiesThinkingAntihypertensive AgentsHydroxymethylglutaryl-CoA Reductase InhibitorsAntihypertensivesCommunity dwellingDementiaMedication adherenceOlder adults

Identifiers

PMID30764775
PMCPMC6376744

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.