Community-dwelling people with dementia spent most of the year at home after STEMI catheterisation

The edition in brief

Among 117,318 Medicare beneficiaries aged 65 or over who presented with STEMI and had cardiac catheterisation between 2017 and 2022, those with dementia living in the community spent an adjusted 38 fewer days at home over the following year than those without dementia, but more than half still spent over 300 days at home. For nursing home residents with dementia, outcomes were markedly worse, with one-year survival of 42%. The authors conclude that dementia alone should not deter appropriate STEMI care, and that decisions should rest on cognitive status, residence and goals. A Hong Kong randomised trial of 198 older adults at risk of abuse found that four sessions of motivational interviewing by advocates reduced minor psychological aggression and caregiver neglect and improved self-efficacy and social support against a wait-list control. A network meta-analysis of 24 trials in mild cognitive impairment and dementia suggested cognitive training, physical exercise and health education improved cognitive test scores, but the effect sizes are implausibly large and heterogeneous. The RESILIENT trial found no difference in 12-month readmissions with three months of mobile cardiac rehabilitation in older adults with ischaemic heart disease. The pearl covers asking about abuse privately.