Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
1citing 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
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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
9 authors.
Matthew E GrowdonDivision of Geriatrics, University of California, San Francisco, San Francisco, California, United States.ORCID 0000-0001-5997-4406
Bocheng JingDivision of Geriatrics, University of California, San Francisco, San Francisco, California, United States.
W James DeardorffDivision of Geriatrics, University of California, San Francisco, San Francisco, California, United States.ORCID 0000-0002-7947-3008
Earl J MorrisDepartment of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, Florida, United States.ORCID 0000-0002-6092-8906
W John BoscardinDivision of Geriatrics, University of California, San Francisco, San Francisco, California, United States.
Leah J BlankDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, United States.ORCID 0000-0001-8719-6752
Tasce BongiovanniDepartment of Surgery, University of California, San Francisco, San Francisco, California, United States.
Kenneth S BoockvarDivision of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, United States.ORCID 0000-0003-1165-5558
Michael A SteinmanDivision of Geriatrics, University of California, San Francisco, San Francisco, California, United States.ORCID 0000-0002-9564-9480
Funding
VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Louise C. Walter · 2013 to 2026
$19.9M
Institutional Career Development Core SupplementKL2TR001870 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANAYA, ALKA M., SARKAR, URMIMALA · 2016 to 2025
$19.7M
Unnecessary and Harmful Medication Use in Older Adults with DementiaP01AG066605 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI MELISSA Diane ALDRIDGE · 2020 to 2026
$17.7M
The U.S. Deprescribing Research NetworkR33AG086944 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI CYNTHIA Melinda BOYD, MICHAEL A. STEINMAN · 2024 to 2026
$2.5M
Prescribing cascades in older adults with and without dementiaK24AG049057 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEINMAN, MICHAEL A. · 2015 to 2025
$1.8M
Optimizing medication use and support among people with dementia who live aloneK76AG088411 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Matthew Evan Growdon · 2024 to 2026
$804k
Seizure, cognitive change and dementia: Understanding the use and safety of anti-seizure medicationsK23AG080163 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Leah Blank · 2023 to 2026
$664k
Prolonged Use of Pain Medication Past the Postoperative Period in Older AdultsK23AG073523 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BONGIOVANNI, TASCE RIIKA SIMON · 2022 to 2025
$653k
Medication risks and challenges among people with dementia who live aloneR03AG078804 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GROWDON, MATTHEW EVAN · 2022 to 2023
$323k
A comprehensive prognostic model for older adults discharged to skilled nursing facilities.R03AG082859 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DEARDORFF, WILLIAM JAMES · 2023 to 2024
backgroundLoop diuretic (LD) use may lead to a prescribing cascade whereby urinary symptoms are ascribed to genitourinary syndromes and treated with urinary symptom medications (USMs). We investigated if LDs lead to increased USM use among older adults and whether this potential prescribing cascade varies across key characteristics.
methodsThis was a prescription sequence symmetry analysis of Veterans Administration data, involving veterans ≥66 years who initiated treatment with LD (2010-2019). USMs were antimuscarinics, beta-3 adrenergic agonists, peripheral alpha-1 blockers, and 5-alpha reductase inhibitors. We calculated the adjusted sequence ratio (aSR), assessing the cascade signal while adjusting for secular trends, and stratified by key variables.
resultsThere were 17 735 veterans who initiated USM within 6 months after LD and 25 190 who initiated USM within 6 months before LD; 99% were male. Unexpectedly, the aSR was 0.74 (95% CI, 0.73-0.76), meaning patients were 26% less likely to initiate USM within 6 months after initiating LD versus 6 months before. This inverse relationship held in men (aSR, 0.74, 95% CI, 0.72-0.76) but was null in women (aSR, 1.00, 95% CI, 0.80-1.26). In men without baseline urinary symptoms, we observed the LD-USM cascade in patients with heart failure (aSR 1.52, 95% CI, 1.41-1.63) and multimorbidity (eg, Charlson fourth quartile, aSR 1.24, 95% CI, 1.10-1.39).
conclusionsWe did not find evidence for an LD-USM cascade among predominantly male older adults overall. Clinicians may underprescribe USMs in patients receiving LDs, perhaps due to strong attribution of urinary symptoms to LD use.
Indexed as
Practice Patterns, Physicians'Sodium Potassium Chloride Symporter InhibitorsAgedAged, 80 and overDrug PrescriptionsFemaleHumansMaleUnited StatesSodium Potassium Chloride Symporter InhibitorsPolypharmacyPrescribing cascadesPrescription sequence symmetry analysis
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.
Loop diuretics and subsequent use of urinary symptom medications in older adults: evaluation of a possible prescribing cascade. · full record | OpenQuestion