Dementia patients more likely to get implanted pacemakers, study says

July 28, 2014

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.

Explore further: Examining lifetime intellectual enrichment and cognitive decline in older patients

Related Stories

Examining lifetime intellectual enrichment and cognitive decline in older patients

June 23, 2014
Higher scores that gauged education (years of school completed) and occupation (based on attributes, complexities of a job), as well as higher levels of mid/late-life cognitive activity (e.g., reading books, participating ...

Late-life depression associated with prevalent mild cognitive impairment, increased risk of dementia

December 31, 2012
Depression in a group of Medicare recipients ages 65 years and older appears to be associated with prevalent mild cognitive impairment and an increased risk of dementia, according to a report published Online First by Archives ...

Cardiac disease linked to higher risk of mental impairment

January 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 ...

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 ...

Atrial arrhythmias detected by pacemakers increase risk of stroke

January 11, 2012
An irregular heartbeat that you don't even feel but can be picked up by a pacemaker is associated with a significantly increased risk of stroke, says a new McMaster University study.

Heart disease linked with dementia in older postmenopausal women

December 18, 2013
Heart disease may put older postmenopausal women at higher risk for decreased brain function such as dementia, according to new research in Journal of the American Heart Association.

Recommended for you

Nature or nurture? Innate social behaviors in the mouse brain

October 18, 2017
Adult male mice have a simple repertoire of innate, or instinctive, social behaviors: When encountering a female, a male mouse will try to mate with it, and when encountering another male, the mouse will attack. The animals ...

Brain activity predicts crowdfunding outcomes better than self-reports

October 18, 2017
Surveys and self-reports are a time-honored way of trying to predict consumer behavior, but they have limitations. People often give socially desirable answers or they simply don't know or remember things clearly.

Navigational view of the brain thanks to powerful X-rays

October 18, 2017
If brain imaging could be compared to Google Earth, neuroscientists would already have a pretty good "satellite view" of the brain, and a great "street view" of neuron details. But navigating how the brain computes is arguably ...

'Wasabi receptor' for pain discovered in flatworms

October 18, 2017
A Northwestern University research team has discovered how scalding heat and tissue injury activate an ancient "pain" receptor in simple animals. The findings could lead to new strategies for analgesic drug design for the ...

Changing stroke definitions is causing chaos, warns professor

October 18, 2017
Proposals to change the definitions of stroke and related conditions are causing confusion and chaos in clinical practice and research, a Monash University associate professor has warned.

Brain-machine interfaces to treat neurological disease

October 18, 2017
Since the 19th century at least, humans have wondered what could be accomplished by linking our brains – smart and flexible but prone to disease and disarray – directly to technology in all its cold, hard precision. Writers ...

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.