{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:14:16Z","timestamp":1790338456038,"version":"4.1.0"},"reference-count":6,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2021,5]]},"abstract":"Abstract<\/jats:title>\n \n Importance<\/jats:title>\n The impact of pre\u2010existing cognitive dysfunction on outcomes after transcatheter aortic valve replacement (TAVR) remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To study the association between dementia and post\u2010TAVR outcomes.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Cohort study with propensity\u2010score matching was conducted using the Nationwide Inpatient Sample.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n History of dementia at the time of undergoing TAVR.<\/jats:p>\n <\/jats:sec>\n \n Main outcomes<\/jats:title>\n All\u2010cause in\u2010hospital mortality, stroke, bleeding requiring transfusion, acute kidney injury, post\u2010procedural vascular complications, post\u2010procedural pacemaker implantation, length of stay, in\u2010hospital delirium, and discharge disposition in patients with and without dementia undergoing TAVR.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 57,805 patients undergoing TAVR, 2910 (5.0%) had a diagnosis of dementia. Propensity\u2010score matching yielded 2895 matched pairs of patients. TAVR was associated with an increased risk of bleeding requiring transfusion (14.7% vs 8.6%, odd ratio (OR) 1.82 [95% confidence interval (CI) 1.26\u20132.63];\n p<\/jats:italic>\n \u2009<\u20090.01), discharge to a rehabilitation facility (45.8% vs 31.6%, OR 2.27 [95% CI 1.67\u20133.08];\n p<\/jats:italic>\n \u2009<\u20090.001), in\u2010hospital delirium (7.4% vs 3.6%, OR 2.13 [95% CI 1.26\u20133.61];\n p<\/jats:italic>\n \u2009<\u20090.01), increased length of stay (6.75\u2009\u00b1\u20090.07\u2009days vs 6.11\u2009\u00b1\u20090.06\u2009days, slope\u00a0=\u00a01.11 [95% CI 1.03\u20131.19];\n p<\/jats:italic>\n \u2009<\u20090.01), but comparable in\u2010hospital mortality (2.1% vs 2.6%, OR 1.26 [95% CI 0.57\u20132.79];\n p<\/jats:italic>\n \u00a0=\u00a00.57] in patients with dementia compared with patients without dementia.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and relevance<\/jats:title>\n This study found that patients with dementia undergoing TAVR had a longer hospital stay as well as higher rates of discharge to a rehabilitation facility and in\u2010hospital delirium, which may indicate debility and functional decline during hospitalization; however, in\u2010hospital mortality and other outcomes were comparable between the two groups. TAVR candidates should be subjected to a comprehensive geriatric and cognitive assessment to help risk\u2010stratify them for potential post\u2010procedural functional decline. Prospective studies aimed at standardizing cognitive scoring and evaluating the post\u2010procedural quality of life are needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.17048","type":"journal-article","created":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T21:42:01Z","timestamp":1613252521000},"page":"1363-1369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Outcomes of transcatheter aortic valve replacement in patients with cognitive dysfunction"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-380X","authenticated-orcid":false,"given":"Vardhmaan","family":"Jain","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Kalra","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland Ohio USA"},{"name":"Section of Cardiovascular Research, Heart, Vascular and Thoracic Department Cleveland Clinic Akron General Akron Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Siyab","family":"Panhwar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tulane University New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agam","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Nowacki","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirtipal","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Icahn School of Medicine at Mount Sinai (Morningside) New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanush","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Houston Methodist Hospital Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichole L.","family":"Ineman","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Research, Heart, Vascular and Thoracic Department Cleveland Clinic Akron General Akron Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safi U.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine West Virginia University Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Krishnaswamy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant W.","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Puri","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir R.","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars G.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Thoracic & Cardiovascular Surgery Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anmar","family":"Kanaa'N","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Research, Heart, Vascular and Thoracic Department Cleveland Clinic Akron General Akron Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Lahorra","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Research, Heart, Vascular and Thoracic Department Cleveland Clinic Akron General Akron Ohio USA"},{"name":"Department of Thoracic & Cardiovascular Surgery Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,11]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"U.S. burden of Alzheimer's disease related dementias to double by 2060|CDC Online Newsroom|CDC.https:\/\/www.cdc.gov\/media\/releases\/2018\/p0920-alzheimers-burden-double-2060.html. Accessed August 15 2020."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.015"},{"key":"e_1_2_11_4_1","unstructured":"HCUP Databases. Healthcare Cost and Utilization Project \u2013 Overview of the National (Nationwide) Inpatient Sample (NIS) Agency for Healthcare Research and Quality: Rockville MD;2016.www.hcup-us.ahrq.gov\/nisoverview.jsp. Accessed December 15 2020."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs533"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2018.11.017"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001367"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.17048","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.17048","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.17048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T12:17:22Z","timestamp":1762172242000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.17048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,11]]},"references-count":6,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1111\/jgs.17048"],"URL":"https:\/\/doi.org\/10.1111\/jgs.17048","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,11]]},"assertion":[{"value":"2020-10-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}