Evidence map›Paper›PMID 40503752›Full record

ArticleJournal of the American Geriatrics Society2025

Household Wealth and Potentially Inappropriate Medications in Persons With Dementia: Role of Comorbidities and Caregivers.

W James Deardorff, Bocheng Jing, Matthew E Growdon, Brian Motmans, W John Boscardin, Leah J Blank, Kenneth S Boockvar, Michael A Steinman

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Trial
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

8 authors.

W James DeardorffDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-7947-3008
Bocheng JingDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Matthew E GrowdonDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0001-5997-4406
Brian MotmansSan Francisco State University, San Francisco, California, USA.
W John BoscardinDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Leah J BlankDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID 0000-0001-8719-6752
Kenneth S BoockvarDivision of Gerontology, Geriatrics, and Palliative Care, University of Alabama, Birmingham, Alabama, USA.ORCID 0000-0003-1165-5558
Michael A SteinmanDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-9564-9480

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Louise C. Walter · 2013 to 2026
$19.9M
Institutional Career Development Core SupplementKL2TR001870 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANAYA, ALKA M., SARKAR, URMIMALA · 2016 to 2025
$19.7M
Unnecessary and Harmful Medication Use in Older Adults with DementiaP01AG066605 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI W. JOHN BOSCARDIN · 2020 to 2026
$17.7M
The U.S. Deprescribing Research NetworkR33AG086944 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI CYNTHIA Melinda BOYD, MICHAEL A. STEINMAN · 2024 to 2026
$2.5M
Prescribing cascades in older adults with and without dementiaK24AG049057 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STEINMAN, MICHAEL A. · 2015 to 2025
$1.8M
Optimizing medication use and support among people with dementia who live aloneK76AG088411 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Matthew Evan Growdon · 2024 to 2026
$804k
Seizure, cognitive change and dementia: Understanding the use and safety of anti-seizure medicationsK23AG080163 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Leah Blank · 2023 to 2026
$664k
Medication risks and challenges among people with dementia who live aloneR03AG078804 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GROWDON, MATTHEW EVAN · 2022 to 2023
$323k
A comprehensive prognostic model for older adults discharged to skilled nursing facilities.R03AG082859 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DEARDORFF, WILLIAM JAMES · 2023 to 2024
$323k
AHRQ HHS K12 HS026383AHRQ HHS K12HS026383NCATS NIH HHS KL2 TR001870NCATS NIH HHS KL2TR001870NIA NIH HHS K23 AG080163NIA NIH HHS K23AG080163NIA NIH HHS K24 AG049057NIA NIH HHS K24AG049057NIA NIH HHS K76 AG088411NIA NIH HHS K76AG088411NIA NIH HHS P01 AG066605NIA NIH HHS P01AG066605NIA NIH HHS P30 AG044281NIA NIH HHS P30AG044281NIA NIH HHS R03 AG078804NIA NIH HHS R03AG078804NIA NIH HHS R03 AG082859NIA NIH HHS R03AG082859NIA NIH HHS R33 AG086944NIA NIH HHS R33AG086944
6 · The paper itself

Abstract

backgroundThe association between lower socioeconomic status and increased potentially inappropriate medications (PIMs) among older adults, as seen in some studies, is infrequently studied in persons with dementia (PWD). This association may additionally be impacted by multimorbidity and caregiver support in PWD. Thus, we examined the association between wealth and PIMs in PWD and the effects of comorbidities and caregivers.

methodsWe included community-dwelling adults aged ≥ 66 with dementia in the Health and Retirement Study (2008-2018). PIMs included sedative-hypnotics, strongly anticholinergics, and medications from 2019 Beers and STOPP-Version 2 criteria. The primary outcome was a prescription for ≥ 1 PIM. We used logistic regression with national survey weights to examine the association between household wealth (above vs. below sample median) and ≥ 1 PIM through 4 models: (1) unadjusted, (2) adjusted for demographics (age, sex, race/ethnicity), 3) Model 2 + comorbidity count (range 0-7), (4) Model 3 + caregiver type (no caregiver, paid caregiver, unpaid caregiver only).

resultsThe cohort consisted of 1475 PWD (median age 84, 67% female, 15% Black, median household wealth $86,000 (IQR 2000-315,000), 49% with unpaid caregiver only, 23% with paid caregiver). Overall, 76% received ≥ 1 PIM. Adjusting for demographics, PWD with below median wealth showed increased odds of receiving ≥ 1 PIM (OR = 1.44, 95% CI = 1.07-1.93). This association was not statistically significant after adjusting for comorbidity count (OR = 1.26, 95% CI = 0.93-1.70). In a stratified analysis by comorbidity count adjusting for demographics and wealth, paid caregiver presence was associated with increased odds of PIMs among individuals with ≤ 2 chronic conditions (OR = 2.60, 95% CI = 1.44-4.69) but not with ≥ 3 chronic conditions (OR = 0.90, 95% CI = 0.50-1.62) (p = 0.02 for interaction).

conclusionsAmong PWD, the association between lower wealth and increased odds of PIMs was no longer statistically significant after adjusting for comorbidity count. Caregiving status had a complex relationship with PIMs based on comorbidity burden.

Indexed as

CaregiversDementiaInappropriate PrescribingPotentially Inappropriate Medication ListAgedAged, 80 and overComorbidityFemaleHumansIndependent LivingMaleSocial ClassSocioeconomic FactorsUnited Statescaregivingmultimorbiditypotentially inappropriate medicationswealth

Identifiers

PMID40503752
PMCPMC12237144

What Socratic holds

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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.