Dementia patients more likely to get implanted pacemakers, study says

People with dementia are more likely to get implanted pacemakers for heart rhythm irregularities, such as atrial fibrillation, than people who don't have cognitive difficulties, according to researchers at the University of Pittsburgh School of Medicine. In a research letter published online today in JAMA Internal Medicine, the researchers noted the finding runs counter to expectations that less aggressive interventions are the norm for patients with the incurable and disabling illness.

To look at the relationships between cognitive status and implantation of a pacemaker, lead investigator Nicole Fowler, Ph.D., a health services researcher formerly at the Pitt School of Medicine, and her team examined data from 33 Alzheimer Disease Centers (ADCs) entered between September 2005 and December 2011 into the National Alzheimer's Coordinating Center (NACC) Uniform Data Set.

Data from more than 16,000 people who had a baseline and at least one follow-up visit at an ADC were reviewed. At baseline, 48.5 percent of participants had no , 21.3 percent had a (MCI), and 32.9 percent had dementia.

The researchers found that participants with cognitive impairment were significantly older and more likely to be male, have , and a history of stroke. Rates of and were similar among the groups.

The likelihood of getting a pacemaker, a device that regulates the heart beat, was lowest for those who had no and highest for dementia patients.

"Participants who had dementia before assessment for a new pacemaker were 1.6 times more likely to receive a pacemaker compared to participants without cognitive impairment, even after clinical factors were taken into account," said Dr. Fowler, now at Indiana University. "This was a bit surprising because aggressive interventions might not be appropriate for this population, whose lives are limited by a severely disabling disease. Future research should explore how doctors, patients and families come to make the decision to get a pacemaker."

There was no difference among the groups in the rates of implantation of cardioverter defibrillators, which deliver a small shock to get the heart to start beating again if it suddenly stops.

add to favorites email to friend print save as pdf

Related Stories

Cardiac disease linked to higher risk of mental impairment

Jan 28, 2013

Cardiac disease is associated with increased risk of mild cognitive impairment such as problems with language, thinking and judgment—particularly among women with heart disease, a Mayo Clinic study shows. Known as nonamnestic ...

Recommended for you

New test to help brain injury victims recover

6 hours ago

A dynamic new assessment for helping victims of trauma to the brain, including those suffering from progressive conditions such as dementia, has been developed by a clinical neuropsychologist at the University ...

See-through sensors open new window into the brain

9 hours ago

(Medical Xpress)—Developing invisible implantable medical sensor arrays, a team of University of Wisconsin-Madison engineers has overcome a major technological hurdle in researchers' efforts to understand ...

User comments