Puheenjohtaja: professori Reijo Sund, It\u00e4-Suomen yliopisto<\/strong><\/p>\n\n\n\n Barkat Babar, Mai Vu, Marjaana Koponen, Heidi Taipale, Antti Tanskanen, Jari Tiihonen, Raimo Kettunen, Miia Tiihonen, Sirpa Hartikainen, Anna-Maija Tolppanen<\/strong><\/p>\n\n\n\n Background Methods Results Sarianna Ilmaniemi<\/strong><\/p>\n\n\n\n Tausta Tavoitteet Aineisto ja menetelm\u00e4t Tulokset Johtop\u00e4\u00e4t\u00f6kset Anne Paakinaho, N. Karttunen, M. Taipale, A. M. Tolppanen, S. Hartikainen, M. Tiihonen<\/strong><\/p>\n\n\n\n Background Objective Method Results Conclusions Blair Rajam\u00e4ki, Marjaana Koponen, Sirpa Hartikainen, Anna-Maija Tolppanen<\/strong><\/p>\n\n\n\n Introduction Methods Results Key conclusions Sessio 7: Rekisteriaineistot vaikuttavuustutkimuksessa Puheenjohtaja: professori Reijo Sund, It\u00e4-Suomen yliopisto 7.1 Prevalence of oral anticoagulants use in people with and without Alzheimer\u2019s disease Barkat Babar, Mai Vu, Marjaana Koponen, Heidi Taipale, Antti Tanskanen, Jari Tiihonen, Raimo Kettunen, Miia Tiihonen, Sirpa Hartikainen, Anna-Maija Tolppanen BackgroundCardio- and cerebrovascular diseases are more common in people with Alzheimer\u2019s disease […]<\/p>\n","protected":false},"author":44,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"footnotes":""},"class_list":["post-1470","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\n7.1 Prevalence of oral anticoagulants use in people with and without Alzheimer\u2019s disease<\/h2>\n\n\n\n
Cardio- and cerebrovascular diseases are more common in people with Alzheimer\u2019s disease (AD) than general population. However, it is unknown whether the use of oral anticoagulants (OAC) is affected by AD diagnosis. We investigated the prevalence of OAC use in relation to AD diagnosis, and compared to a matched cohort without AD. <\/p>\n\n\n\n
Medication Use and Alzheimer\u2019s disease (MEDALZ) cohort includes 70718 Finnish people who received a clinically verified AD diagnosis between 2005-2011. Point prevalence of OAC during a two-week time period was calculated every six months from five years before to five years after AD diagnosis, and compared to matched cohort without AD. OAC use was obtained from the prescription register by Anatomical Therapeutic Chemical (ATC) Classification system (B01A) with Prescription to drug use periods (PRE2DUP) method. The difference regarding OAC prevalence among person with and without AD was calculated by using GEE (generalized estimating equations) model. <\/p>\n\n\n\n
OACs were more commonly used by people with AD before the AD diagnosis (OR = 1.17; 95% CI = 1.14-1.21). At the time of AD diagnosis, prevalence of OAC use was a bit higher in persons with AD than without AD (22% and 19%, respectively), but the use in people with AD began to decline gradually after AD diagnosis (OR = 0.94; 95% CI = 0.92-0.96) whereas usage increased continuously in persons without AD. Warfarin was the most common OAC in both AD (15% of users) and non-AD groups (13% of users).<\/p>\n\n\n\n7.2 P\u00e4\u00e4n vammojen ja aivovammojen ilmaantuvuus Parkinsonin tautia sairastavilla ja heid\u00e4n verrokeillaan<\/h2>\n\n\n\n
V\u00e4est\u00f6n ik\u00e4\u00e4ntyess\u00e4 Parkinsonin taudin esiintyvyys on kasvanut. Parkinsonin tautia sairastavilla on huomattavasti korkeampi kaatumisriski sek\u00e4 riski kaatumisiin liittyviin vammoihin. Erityisesti p\u00e4\u00e4n vammat ja aivovammat voivat merkitt\u00e4v\u00e4sti vaikuttaa henkil\u00f6n toimintakykyyn ja elinajan ennusteeseen.<\/p>\n\n\n\n
Tutkimuksessa selvitettiin p\u00e4\u00e4n vammojen ja aivovammojen ilmaantuvuutta Parkinsonin tautia sairastavilla verrattuna henkil\u00f6ihin, joilla ei ole diagnosoitu Parkinsonin tautia.<\/p>\n\n\n\n
T\u00e4ss\u00e4 rekisteripohjaisessa kohorttitutkimuksessa k\u00e4ytettiin FINPARK-aineistoa, joka koostuu henkil\u00f6ist\u00e4, joille on Parkinsonin taudin perusteella my\u00f6nnetty erityiskorvausoikeus Parkinsonin taudin l\u00e4\u00e4kkeisiin vuosina 1996-2015 (N=21,683). Lis\u00e4ksi jokaista Parkinsonin tautia sairastavalle on poimittu seitsem\u00e4n i\u00e4n, sukupuolen ja asuinpaikan perusteella kaltaistettua verrokkia. Jos seitsem\u00e4\u00e4 verrokkia ei ollut tunnistettavissa, poimittiin niin monta verrokkia kuin mahdollista. Seuranta-aika alkoi indeksitapauksen Parkinsonin taudin diagnoosip\u00e4iv\u00e4st\u00e4 ja loppui p\u00e4\u00e4n vammaan, kuolemaan tai aineiston seuranta-ajan loppuun 31.12.2016. T\u00e4m\u00e4 tutkimus rajattiin niihin Parkinsonin tautia sairastaviin (n=20 059) ja heid\u00e4n verrokkeihinsa (n=130 186), joilla ei ollut ennen seurannan alkua aiempaa p\u00e4\u00e4n vammaa. P\u00e4\u00e4n vammat (ICD-10 koodit S00.0-S09.9 ) ja aivovammat (S06.0-S06.9) tunnistettiin THL:n yll\u00e4pit\u00e4m\u00e4st\u00e4 terveydenhuollon hoitoilmoitusrekisterist\u00e4. Vammojen riski\u00e4 Parkinsonin tautia sairastavilla arviontiin joustavalla parametrisella mallilla.<\/p>\n\n\n\n
P\u00e4\u00e4n vammojen ilmaantuvuus Parkinsonin tautia sairastavilla oli 17,3 (n=2301, 11,5%) ja verrokeilla 9,1 (n=9087, 7,2%) tuhatta henkil\u00f6vuotta kohden. Aivovammojen ilmaantuvuudet olivat vastaavasti 8,6 (n=1138, 5,7%) ja 4,9 (n=4878, 3,9%). <\/p>\n\n\n\n
Parkinsonin tautia sairastavilla on korkeampi p\u00e4\u00e4n vammojen ja aivovammojen ilmaantuvuus verrattuna henkil\u00f6ihin, joilla ei ole Parkinsonin taudin diagnoosia. P\u00e4\u00e4h\u00e4n kohdistuvat vammat voivat heikent\u00e4\u00e4 Parkinsonin tautia sairastavien ennustetta sek\u00e4 toimintakyky\u00e4 ja johtaa omatoimisuuden heikkenemiseen jo taudin varhaisessa vaiheessa. Parkinsonin tautia sairastavilla on keskeist\u00e4 kiinnitt\u00e4\u00e4 huomiota kaatumisten ja niihin liittyvien vammojen ennaltaehk\u00e4isyyn.<\/p>\n\n\n\n7.3 Incidence of muscle relaxant use in relation to diagnosis of Parkinson\u2019s disease<\/h2>\n\n\n\n
Parkinson\u2019s disease is the second most common neurodegenerative disorder. Parkinson\u2019s disease may have long prodromal period when symptoms are present, but do not fulfil the diagnostic criteria. Motor and non-motor symptoms seem to precede the diagnosis and muscle relaxants could be used as symptomatic drugs.<\/p>\n\n\n\n
To evaluate the incidence of muscle relaxant use in community-dwelling persons with and without Parkinson\u2019s disease from 4 years before to 4 years after the diagnosis of Parkinson\u2019s disease. <\/p>\n\n\n\n
Nationwide register-based cohort included all community-dwelling Finnish persons who received reimbursement of Parkinson\u2019s disease drugs between 2000 and 2015 (N = 17,450) and comparison persons without Parkinson\u2019s disease who were matched for age, gender and region of residence (N = 122,694). Data on muscle relaxant use during 1995\u20132016 were collected from the Prescription Register.<\/p>\n\n\n\n
The incidence of muscle relaxant use was higher among persons with Parkinson\u2019s disease in comparison to persons without Parkinson\u2019s disease from 3 years before the diagnosis until 6 months after the diagnosis. The largest difference in incidence rates was observed at the time of the diagnosis (incidence rate ratio = 2.04, 95% confidence interval = 1.81\u20132.30). Tizanidine was the most frequently initiated muscle relaxant.<\/p>\n\n\n\n
The incidence of muscle relaxant use starts increasing years before the diagnosis of Parkinson\u2019s disease but declines after that. It is important to identify the causes of muscle symptoms to avoid unnecessary muscle relaxant use and consequent adverse effects and events. Non-specific muscle symptoms and consequent muscle relaxant use might be preceding Parkinson\u2019s disease diagnosis.<\/p>\n\n\n\n7.4 Length of hospital stay after hip fracture and readmission rates of persons with and without Alzheimer\u2019s disease<\/h2>\n\n\n\n
Hospital length of stay (LOS) for incident of hip fracture are decreasing, but it is unknown if these changes have negative impacts on vulnerable older patient populations, like those with Alzheimer\u2019s disease (AD). We aimed to assess if persons with and without AD have different LOS for hip fracture, and is the LOS associated with hospital readmissions.<\/p>\n\n\n\n
Utilizing register-based data for a matched cohort study nested in the Medication use and Alzheimer\u2019s disease study (MEDALZ), we collected all community-dwelling persons in Finland diagnosed with AD during 2005-2012, had incident of first hip fracture between 2005 and 2015 after AD diagnosis, and were discharged alive from an acute care hospital. Hospital LOS and hospital readmissions within 30-days and 90-days were compared between those with and without AD and risk of readmission was assessed using binary logistic regression analysis. <\/p>\n\n\n\n
In this matched cohort study of 12,532 persons (mean age 84.6 years (95% CI: 84.5-84.7), 76.8% women), the median LOS in an acute care hospital was one day shorter for those with AD (median 4 days, IQR 3-7) than those without AD (median 5 days, IQR 3-7). However, the AD cohort had respectively 6 days and 5 days longer median LOS in a community hospital, and total hospital stay compared to the non-AD cohort. Those with AD had fewer readmissions within 30-days (10.7%) and 90-days (16.9%) compared to those without AD (13.3% 30-days and 20.7% 90-days). Both cohorts had a reduced readmission risk within 30-days when the LOS in an acute care hospital was 4-14 days, compared to a LOS <4 days.<\/p>\n\n\n\n
Short LOS in acute care hospitals may be associated with poor health outcomes for vulnerable older populations after hip fracture.<\/p>\n","protected":false},"excerpt":{"rendered":"