Research letter examines pacemaker use in patients with cognitive impairment

July 28, 2014

Dr. Nicole R. Fowler and her fellow reserachers have found that patients with dementia were more likely to receive a pacemaker then patients without cognitive impairment.

Older adults with mild (MCI) and dementia can have co-existing cardiac illnesses and that makes them eligible for therapy with devices to correct rhythm abnormalities. But the risks and benefits need to be weighed carefully with patients, families and clinicians.

The authors examined data from the National Alzheimer Coordinating Center Uniform Data Set gathered from 33 Alzheimer Disease Centers from September 2005 through December 2011. There were 16,245 participants with a baseline visit and at least one follow-up.

At baseline, 7,446 participants (45.8 percent) had no cognitive impairment, 3,460 (21.3 percent) had MCI and 5,339 (32.9 percent) had dementia. Participants who had dementia at the visit before being assessed for a pacemaker were 1.6 times more likely to receive a pacemaker compared with participants without cognitive impairment and participants with MCI were 1.2 times more likely. Over the seven-year study period, rates of pacemakers were 4 per 1,000 person-years for participants without cognitive impairment, 4.7 per 1,000 person-years for participants with MCI and 6.5 per 1,000 person-years for participants with dementia.

Patients with were more likely to receive a than patients without cognitive impairment, even after adjusting for clinical risk factors. This runs counter to the normative expectation that patients with a serious life-limiting and cognitively disabling illness might be treated less aggressively. While it is possible that unmeasured confounding by indication explains this observation, future research should explore the patient, caregiver and clinician influences on decision making regarding cardiac devices in this population.

Explore further: Amnestic mild cognitive impairment doubles risk of death

More information: JAMA Intern Med. Published online July 21, 2014. DOI: 10.1001/jamainternmed.2014.3450.

Related Stories

Amnestic mild cognitive impairment doubles risk of death

July 16, 2012

Researchers at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center have found that people with a form of mild cognitive impairment (MCI), a risk factor for developing Alzheimer's disease, ...

About one-quarter of patients with MCI progress to dementia

March 12, 2014

(HealthDay)—About 22 percent of patients with mild cognitive impairment (MCI) progress to dementia within three years, and depression symptoms modify the prognosis, according to a study published in the March/April issue ...

Recommended for you

Oligodendrocytes induce motor neuron death in ALS

September 27, 2016

A first-of-its-kind oligodendrocyte in vitro model shows that human cells normally supportive of motor neuron function play an active role in amyotrophic lateral sclerosis pathogenesis – and this discovery may point the ...

The language of senses

September 26, 2016

Sight, touch and hearing are our windows to the world: these sensory channels send a constant flow of information to the brain, which acts to sort out and integrate these signals, allowing us to perceive the world and interact ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.