LAUSR

Limited data are available on the prevalence and correlates of statin use for secondary cardiovascular (CV) prevention in the older adult population. We used data of older adults (65-79 years) with established atherosclerotic CV disease from the cross-sectional Italian Health Examination Survey (HES) 2008-2012 study to address this issue. Lifestyles, CV risk factors, chronic diseases and therapies were assessed using standardized procedures. A comprehensive geriatric assessment was performed to evaluate cognitive function, disability in basic and instrumental activities of daily living (ADL and IADL), mobility and polypharmacy. Multiple regression analyses were performed to identify independent correlates of statin use. 392 participants (mean age 72.1±4.4 years, 61.5% men) were considered for this analysis. Coronary heart disease (CHD) was identified in 67.1% of them, cerebrovascular disease in 23.5%, and peripheral artery disease (PAD) in 18.1%. 190 (48.5%) were statin users. By multiple regression analysis, functional disability (OR=0.81; 95%CI=0.71-0.92; p=.002), cognitive impairment (OR=0.87; 95%CI=0.78-0.98; p=.018) and polypharmacy (OR=0.86; 95%CI=0.75-0.98; p=.035) predicted statin non-use, whereas having hypertension (OR=1.19; 95%CI=1.05-1.34; p=.005), diabetes mellitus (OR=1.14; 95%CI=1.03-1.27; p=.013) or a previous myocardial revascularization (OR=1.31; 95%CI=1.16-1.48; p<.001) predicted statin use. Significant interaction terms were observed between cerebrovascular disease, PAD, cognitive impairment and disability in predicting statin non-use. Statin underuse in older adults 65-79 years with CV disease, and thus suboptimal secondary CV prevention, is highly prevalent despite current guidelines recommendations. Common geriatric conditions are associated with statin non-use. Such results support the need for improving the awareness of statin treatment for secondary CV prevention.