Evidence map›Paper›PMID 34647409›Full record

ArticleDiabetes, obesity & metabolism2022

Effects of dipeptidyl peptidase-4 inhibitors and sulphonylureas on cognitive and physical function in nursing home residents.

Andrew R Zullo, Matthew S Duprey, Robert J Smith, Roee Gutman, Sarah D Berry, Medha N Munshi, David D Dore

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes, obesity & metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Comparative safety of sulfonylureas among U.S. nursing home residents.Journal of the American Geriatrics Society · 2023
    Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Andrew R ZulloDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID 0000-0003-1673-4570
Matthew S DupreyDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Robert J SmithDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Roee GutmanDepartment of Biostatistics, Brown University School of Public Health, Providence, Rhode Island, USA.
Sarah D BerryDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Medha N MunshiMarcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA.
David D DoreDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID 0000-0003-0810-6662
Brown University · USBeth Israel Deaconess Medical Center · USExponent (United States) · USJoslin Diabetes Center · US

Funding

NIA NIH HHS R01 AG045441NIA NIH HHS R01 AG065722NIA NIH HHS R21 AG061632NIA NIH HHS RF1 AG061221
6 · The paper itself

Abstract

aimsDipeptidyl peptidase-4 inhibitors (DPP4Is) may mitigate hypoglycaemia-mediated declines in cognitive and physical functioning compared with sulphonylureas (SUs), yet comparative studies are unavailable among older adults, particularly nursing home (NH) residents. We evaluated the effects of DPP4Is versus SUs on cognitive and physical functioning among NH residents. MATERIALS AND

methodsThis new-user cohort study included long-stay NH residents aged ≥65 years from the 2007-2010 national US Minimum Data Set (MDS) clinical assessments and linked Medicare claims. We measured cognitive decline from the validated 6-point MDS Cognitive Performance Scale, functional decline from the validated 28-point MDS Activities of Daily Living scale, and hospitalizations or emergency department visits for altered mental status from Medicare claims. We compared 180-day outcomes in residents who initiated a DPP4I versus SU after 1:1 propensity score matching using Cox regression models.

resultsThe matched cohort (N = 1784) had a mean ± SD age of 80 ± 8 years and 73% were women. Approximately 46% had no or mild cognitive impairment and 35% had no or mild functional impairment before treatment initiation. Compared with SU users, DPP4I users had lower 180-day rates of cognitive decline [hazard ratio (HR) = 0.61, 95% confidence interval (CI) 0.31-1.19], altered mental status events (HR = 0.71, 95% CI 0.39-1.27), and functional decline (HR = 0.89, 95% CI 0.51-1.56), but estimates were imprecise.

conclusionsRates of cognitive and functional decline may be reduced among older NH residents using DPP4Is compared with SUs, but larger studies with greater statistical power should resolve the remaining uncertainty by providing more precise effect estimates.

Indexed as

Dipeptidyl-Peptidase IV InhibitorsActivities of Daily LivingAgedAged, 80 and overCognitionCohort StudiesDipeptidyl-Peptidases and Tripeptidyl-PeptidasesFemaleHumansMedicareNursing HomesRetrospective StudiesUnited StatesDipeptidyl-Peptidase IV InhibitorsDipeptidyl-Peptidases and Tripeptidyl-Peptidasesdiabetes mellitusdipeptidyl-peptidase-4 inhibitorsfrailtynursing homessulphonylurea compounds

Identifiers

PMID34647409
PMCPMC8741644
OpenAlexW3206699892

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.