A population-based cohort, including data from four registers, encompassing inhabitants in Region Västra Götaland, Sweden, was used.
Statin users were defined as those filling statin prescriptions ≥ 75% of the year 2010.
Information on living conditions was obtained from the Social Service Register.
If an individual had a record in this register in 2007, 2008, 2009, or 2010, he/she was classified as living in a nursing home and if not, community dwelling.
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To facilitate treatment decisions, the Systematic Coronary Risk Evaluation (SCORE) system has been developed, illustrating the risk for an individual according to a selection of important predictors .
At older ages, treatment decisions are complicated by the lack of conclusive evidence of a positive benefit-risk balance, regarding both secondary and primary prevention; the clinical trials do not include a sufficient number of older individuals. In addition to the absence of conclusive evidence regarding beneficial effects, decisions on drug treatment in the oldest old (≥ 80 years of age) are particularly complex because of comorbidities and increased susceptibility to adverse reactions. A Danish study found that 38% of men and 32% of women aged 75–84 years used statins during 2010 .
We used logistic regression to obtain crude and adjusted odds ratios (ORs) with 95% CIs for (i) statin use in individuals with ≥ 1 established indication and (ii) having ≥ 1 established indication in statin users.To the best of our knowledge, however, statin use in the oldest old has not been compared to the use in the younger elderly.Therefore, we do not know to what extent the limited evidence base and other complexities attached to the oldest olds are associated with statin treatment practice.In order to characterize individuals at the beginning of 2010, we estimated the number of drugs in the medication list, recorded as a continuous variable, on December 31, 2009, as a proxy for burden of disease .In short, for individuals receiving their drugs via ordinary prescriptions, a medication list was constructed according to the filled prescriptions during the 3-month period preceding this date.