A pacemaker is a surgically implanted device in a patient's chest or abdomen. It has wires that send electrical pulses directly to the heart as a way to correct abnormal heart beats. While it can help the patient in getting a better quality of life, some people believe that it only prolongs the life of a patient with dementia.
Pacemakers are normally used for those with heart rhythm irregularities such as atrial fibrillation. For this reason, the researchers find it difficult to explain the reason why people with dementia would have to use these devices that aid in controlling irregular heart rhythms.
Assistant professor of medicine Nicole Fowler from the University of Pittsburgh says, "It may be completely appropriate. There may be something that we haven't been able to measure that makes people with dementia need them more."
Another important question deals on whether patients with dementia, which is believed to be a progressive and incurable condition, really needed a pacemaker after all.
"We really need to take into account the whole picture and make sure patients understand the implications of the decisions they are making," Fowler adds.
The researchers of the study analyzed data from 16,245 people who the group had seen at 33 Alzheimer's Disease Centers. The gathering and analyzing of data were done between September 2005 and December 2011.
During their initial visit to the centers, they recorded that 46% of the patients showed no evidence of dementia. The next 21% represents those with mild cognitive impairment. The remaining 33% are the ones that are confirmed to have dementia.
As the study progresses, the researchers discovered that four out of every 1,000 patients with no signs of dementia during their first visit would receive a pacemaker every year. This rate is higher among those with mild cognitive impairment which showed a record of 4.7 in every 1,000 people visited. Likewise, patients with dementia had the highest rate of 6.5 for every 1,000 people.
The records show that patients with dementia are more likely to get a pacemaker than their non-dementia affected colleagues by as much as 60%. The study also took account of the patients' sex, race, age, location, blood pressure, heart health, stroke risk and cognitive weakening.
"Medical decisions for patients with dementia are really hard," says Fowler. "We know from the data that families really struggle to make medical decisions. It's important to find out what are some of the things patients and families need to support their decision making."
