Impact of Beta Blockers on Functional Outcomes in Nursing Home Residents After Myocardial Infarction
Year: 2017
Type: conference-abstract
Abstract: Beta blockers are a mainstay of treatment after acute myocardial infarction (AMI). Yet, these medications are commonly not prescribed for older nursing home residents after AMI, in part owing to concerns about potential functional harms and uncertainty of benefit. We conducted a propensity score-matched cohort study of the impact of beta blockers on functional decline, mortality and rehospitalization in the first 90 days after AMI among long stay nursing home residents 65+. The study cohort included 5,496 new beta blocker users and an equal number of non-users. Mean age was 84 years. Beta blocker users were more likely than non-users to experience functional decline (OR 1.14, 95% CI 1.02–1.28). Conversely, beta blocker users were less likely than non-users to die (HR 0.74, 95% CI 0.67–0.83) and had similar rates of re-hospitalization (HR 1.06, 95% CI 0.98–1.14). Nursing home residents with moderate or severe cognitive impairment or severe functional dependency were particularly likely to experience functional decline (OR 1.34, 95% CI 1.11–1.61 and OR 1.32, 95% CI 1.10–1.59, respectively). In contrast, there was little evidence of functional decline in subjects with better cognitive and functional status (ORs 0.99 to 1.05; P value for interaction 0.03 and 0.06, respectively). Mortality benefits of beta blockers were similar across all subgroups. Use of beta blockers after AMI is associated with functional decline in older nursing home residents with substantial cognitive or functional impairment, but not in those with relatively preserved mental and functional abilities. Beta blockers yielded considerable mortality benefit in all groups.
Source: Innovation in Aging
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,977
OpenAlex ID: W2727664194